Study On The Prevalence And Self-management Of Hypertension And Its Impact On Daily Living Activities Among Rural Elderly In Luo Ping County, Yunnan Province

Objective: The aim of this study was to analyze the prevence of hypertension,self-management,and activities of daily living(ADL),and to explore the effects of hypertension prevalence and self-management on ADL among rural elderly in Luoping county of Yunnan Province,so as to provide evidences for promoting healthy ageing in rural areas of Yunnan.Method: A cross-sectional study design was adopted.The rural residents aged≥60 years old in Luoping county.Each participant received questionnaire survey and physical examination.Demographic characteristics,socio-economic status,health status,lifestyle,prevalence of hypertension,self-management and ADL were collected through questionnaires.ADL includes physical activities of daily living(PADL)and instrumental activities of daily living(IADL).Health-related data were collected through on-site physical examination.The Chi-square test was used to analyze the difference in the prevalence of hypertension,self-management behavior,and ADL impairment in different older adults,the Chi-square test and logistic regression analysis were used to explore the effect of the prevalence of hypertension and self-management on ADL of the elderly,with the difference considered statistically significant at P<0.05.Results: In this study,a total of 1000 older adults were surveyed and 962 valid questionnaires were obtained,with a response rate of 96.2%.The prevalence of hypertension among older people in the survey area was 55.7%,with a higher prevalence among illiterate,family history of hypertension,obese and centrally obese older adults(P < 0.05).The prevalence of complication among elderly hypertensive patients in the survey area was 17.4%.The rates of taking medication as prescribed,self-monitoring of blood pressure and taking antihypertensive measures were 82.3%,81.9% and 96.2%,respectively,with the rates of taking steps to reduce blood pressure such as weight control/ weight loss,light diet/salt reduction,increasing exercise,reducing alcohol consumption and quitting smoking being 24.7%,90.2%,46.7%,16.0% and 7.0%respectively.The rate of taking medication as prescribed was higher among elderly hypertensive patients with high per capita annual household income and no comorbidities(P < 0.05);the rate of self-monitoring of blood pressure was higher among elderly hypertensive patients with high per capita annual household income(P< 0.05);There was no statistical significance in the rate of taking antihypertensive measures among elderly hypertension patients with different characteristics(P > 0.05).The prevalence of ADL,PADL and IADL among elderly in the survey area was28.5%,15.4% and 28.1% respectively.Walking had the highest impairment rate(13.2%)while eating had the lowest impairment rate(2.8%)in PADL.In comparison,taking public transport had the highest impairment rate(23.1%)while taking medication had the lowest impairment rate(3.0%)in IADL.ADL impairment rare was higher in females,older,widowed,low annual per capita household income,lived alone,poor self-rated health,not overweight,not currently smoking,not drinking alcohol,lowintensity physical activity and physical activity <3 times per week(P<0.05);PADL impairment rare was higher in older,widowed,lived alone,poor self-rated health,not currently smoking,not drinking alcohol,low-intensity physical activity,physical activity <3 times per week and emotional(P<0.05);IADL impairment rare was higher in females,older,widowed,lived alone,low per capita annual household income,lived alone,poor self-rated health,not overweight,not obese,not currently smoking,not drinking alcohol,low-intensity physical activity and exercised < 3 times per week(P <0.05).The results of multivariate logistic regression showed that older adults with hypertension may have an increased risk of PADL(OR=1.778,95% CI=1.147 to 2.758)and that having hypertensive complications may increase the risk of ADL and IADL(OR=3.105,95% CI=1.238 to 7.785;OR=2.837,95% CI=1.068 to 4.502),whereas the higher the number of self-management behaviors adopted by older hypertensive patients,the lower the risk of ADL and IADL may be.(OR=0.508,95% CI=0.277 to0.931;OR=0.489,95% CI=0.264 to 0.907).Conclusion: The prevalence of hypertension in rural elderly was high in Luoping County.There were weaknesses in self-management behaviour in older hypertensive patients,primarily in the low rate of self-monitoring of blood pressure and the low rate of adopting antihypertensive measures such as weight loss/control,increased exercise,reduced alcohol consumption and smoking cessation;the rate of ADL,PADL and IADL in rural elderly was high;Suffering from hypertension had a negative impact on PADL,hypertension patients with complication had negative impacts on ADL and IADL,whereas conducting good self-management behaviors had positive impacts on ADL and IADL among the elderly in Luoping County.