Self-management and blood pressure control in China: a community-based multicentre cross-sectional study. Issue 3 (20th March 2019)

• Record Type: Journal Article
• Authors: Qu, Zhan; Parry, Monica; Liu, Fang; Wen, Xiulin; Li, Jieqiong; Zhang, Yanan; Wang, Duolao; Li, Xiaomei
• Is Part Of: BMJ open. Volume 9:Issue 3(2019)
• Publication Date: 2019-03-20
• Subjects: hypertension -- self-management -- community care -- sex -- gender; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-025819
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: This study explored the relationship between self-management and blood pressure (BP) control in China. Design: A cross-sectional study. Setting: Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi'an), Southwest (Chengdu) and South (Changsha) of China. Participants: A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg. Outcome measurements: BP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20. Results: A total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99). Conclusions: The individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.