The purpose of this study was twofold: (1) evaluate the adherence to self-management behaviors and (2) examine the association between adherence to self-management behaviors and blood pressure control among Korean older adults (i.e., age ≥ 60 years) with hypertension (HTN).
Methods:
We utilized a descriptive, cross-sectional design to collect data from older adults in Korea who have been on antihypertensive medications at primary care clinics in both rural and urban areas. A revised Self-Care Behavior questionnaire was used to assess HTN self-management behavior. This questionnaire comprised 18 items that measured the degree to which patients practiced self-care behaviors such as diet control, no smoking, moderate alcohol consumption, exercise, stress management, weight control, and taking medication. Respondents were classified as either adherent to self-management behavior, if they reported to practice each behavior at least most of time, or non-adherent, if they did not. Moreover, the blood pressure of participants was measured and recorded twice (e.g., at baseline and at the conclusion of the study), and the average of the two measurements was used for analysis. High blood pressure was defined as systolic blood pressure less than 140 mmHg and diastolic blood pressure less than 80 mmHg. Descriptive statistics and logistic regression analyses were performed.
Results:
The mean age of the participants was 72.13 years (SD = 7.75; range 0–90), of whom 61.8% (n = 97) were female. Approximately 60% of the participants had their blood pressure under control, while the remaining participants still exhibited uncontrolled blood pressure. The majority of participants reported that they practice self-management behaviors. For those participants who exhibited non-adherent behaviors, these behaviors included regular self-weighing, intake of fresh fruit and/or vegetables, regular exercise, and increased physical activity. Although we observed no statistically significant relationship between self-management behaviors and blood pressure control, we did observe a strong relationship between uncontrolled blood pressure and the following three factors: diabetes (OR = 3.142; 95% CI [1.357, 7.282]); living in rural areas (OR = 0.283; 95% CI [0.117, 0.687]); regular medical checkups (OR = 0.097; 95% CI [0.022, 0.427]).
Conclusion:
Although all participants in our study were taking antihypertensive medications, only 40% of them exhibited uncontrolled blood pressure. This finding warrants further study to further understand blood pressure management and self-management behaviors—especially among Korean older adults. Moreover, our findings can enable clinicians to better understand challenges to adherence and guide older adults with self-management to effectively control their blood pressure and HTN.