Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Study Population
2.3. Description of Measures
2.3.1. Compliance Behaviors
2.3.2. Predictor Variables
2.4. Statistical Analysis
2.5. Ethical Statements
3. Results
3.1. General Information
3.2. Univariate Analysis
3.3. Multi-Factor Regression Analysis
3.3.1. Compliance with Medication Behavior
3.3.2. Compliance with Blood Pressure Monitoring Behavior
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Categories | All Participants | Medication Compliance | Blood Pressure Monitoring Compliance | ||
---|---|---|---|---|---|---|
n (%) | No (%) | Yes (%) | No (%) | Yes (%) | ||
Sex | Male | 2958 (46.9) | 26.2 | 73.8 *** | 57.7 | 42.3 * |
Female | 3350 (53.1) | 20.0 | 80.0 | 60.8 | 39.2 | |
Age (years) | 45–54 | 1381 (21.9) | 31.2 | 68.8 *** | 60.2 | 39.8 |
55–64 | 2293 (36.4) | 22.6 | 77.4 | 59.8 | 40.2 | |
65–74 | 1783 (28.3) | 19.3 | 80.7 | 58.6 | 41.4 | |
≥75 | 851 (13.5) | 17.6 | 82.4 | 58.2 | 41.8 | |
BMI (kg/m2) | Normal (18.5–23.9) | 1791 (28.4) | 27.9 | 72.1 *** | 65.0 | 35.0 *** |
Underweight (<18.5) | 187 (3.0) | 23.5 | 76.5 | 69.0 | 31.0 | |
Overweight (24–27.9) | 3266 (51.8) | 21.6 | 78.4 | 56.5 | 43.5 | |
Obese (≥28) | 1064 (16.9) | 18.1 | 81.9 | 56.6 | 43.4 | |
Number of complications | 0 | 1391 (22.1) | 29.3 | 70.7 *** | 63.0 | 37.0 *** |
1 | 1764 (28.0) | 24.5 | 75.5 | 60.4 | 39.6 | |
2 | 1381 (21.9) | 23.4 | 76.6 | 60.5 | 39.5 | |
≥3 | 1772 (28.1) | 15.8 | 84.2 | 54.4 | 45.6 | |
ADL | Normal | 3844 (60.9) | 25.2 | 74.8 *** | 56.8 | 43.2 *** |
Declined | 2464 (39.1) | 19.2 | 80.8 | 63.3 | 36.7 | |
Smoking | No | 4581 (72.6) | 20.9 | 79.1 *** | 58.2 | 41.8 ** |
Yes | 1727 (27.4) | 28.1 | 71.9 | 62.4 | 37.6 | |
Current drinking | No | 4298 (68.1) | 19.7 | 80.3 *** | 58.8 | 41.2 |
Yes | 2010 (31.9) | 29.6 | 70.4 | 60.5 | 39.5 | |
Regular exercise | No | 4032 (63.9) | 22.6 | 77.4 | 59.1 | 40.9 |
Yes | 2276 (36.1) | 23.4 | 76.6 | 59.7 | 40.3 | |
Sleep duration | <6 h | 1944 (30.8) | 21.1 | 78.9 | 62.2 | 37.8 *** |
6–8 h | 3806 (60.3) | 23.6 | 76.4 | 57.1 | 42.9 | |
≥9 h | 558 (8.8) | 23.8 | 76.2 | 64.7 | 35.3 | |
Depressive mood | No | 4153 (65.8) | 24.1 | 75.9 ** | 57.4 | 42.6 *** |
Yes | 2155 (34.2) | 20.5 | 79.5 | 63.1 | 36.9 | |
Cognitive function score | <10 | 2573 (40.8) | 21.3 | 78.7 * | 66.8 | 33.2 *** |
≥10 | 3735 (59.2) | 23.9 | 76.1 | 54.2 | 45.8 | |
Marital status | Non-married | 1088 (17.2) | 22.4 | 77.6 | 61.9 | 38.1 |
Married | 5220 (82.8) | 23.0 | 77.0 | 58.8 | 41.2 | |
Educational level | 0 | 1528 (24.2) | 19.8 | 80.2 ** | 67.4 | 32.6 *** |
6 years | 3253 (51.6) | 23.8 | 76.2 | 60.3 | 39.7 | |
9 years | 950 (15.1) | 22.9 | 77.1 | 54.4 | 45.6 | |
≥10 years | 577 (9.1) | 25.8 | 74.2 | 40.2 | 59.8 | |
Place of residence | Urban | 1861 (29.5) | 20.5 | 79.5 ** | 46.5 | 53.5 *** |
Rural | 4447 (70.5) | 23.9 | 76.1 | 64.7 | 35.3 | |
Personal income | No | 4209 (66.7) | 21.9 | 78.1 ** | 61.7 | 38.3 *** |
Yes | 2099 (33.3) | 24.9 | 75.1 | 54.5 | 45.5 | |
Medical insurance | No | 447 (7.1) | 26.0 | 74.0 | 63.5 | 36.5 |
Yes | 5861 (92.9) | 22.6 | 77.4 | 59.0 | 41.0 | |
Health education | No | 2676 (42.4) | 29.4 | 70.6 *** | 64.2 | 35.8 *** |
Yes | 3632 (57.6) | 18.1 | 81.9 | 55.7 | 44.3 |
Variable | Model 1 OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) | Model 4 OR (95% CI) |
---|---|---|---|---|
Downstream Factors | ||||
Sex (vs. Male) | ||||
Female | 1.33 (1.18–1.50) *** | 1.08 (0.93–1.26) | 1.41 (1.24–1.61) *** | 1.14 (0.97–1.33) |
Age (vs. 45–54) | ||||
55–64 | 1.55 (1.33–1.81) *** | 1.53 (1.31–1.78) *** | 1.60 (1.37–1.87) *** | 1.57 (1.34–1.84) *** |
65–74 | 1.92 (1.62–2.28) *** | 1.86 (1.57–2.22) *** | 1.96 (1.65–2.34) *** | 1.89 (1.58–2.25) *** |
≥75 | 2.23 (1.78–2.79) *** | 2.11 (1.68–2.66) *** | 2.39 (1.89–3.02) *** | 2.25 (1.77–2.85) *** |
BMI (vs. Normal) | ||||
Underweight | 1.06 (0.74–1.52) *** | 1.07 (0.75–1.54) *** | 1.05 (0.73–1.51) *** | 1.07 (0.74–1.54) |
Overweight | 1.50 (1.31–1.72) *** | 1.49 (1.30–1.71) *** | 1.45 (1.26–1.66) *** | 1.44 (1.25–1.65) *** |
Obese | 1.89 (1.56–2.29) *** | 1.85 (1.53–2.25) *** | 1.75 (1.44–2.13) *** | 1.72 (1.41–2.09) *** |
Number of complications (vs. 0) | ||||
1 | 1.24 (1.06–1.46) ** | 1.23 (1.05–1.45) * | 1.21 (1.03–1.43) * | 1.20 (1.02–1.42) * |
2 | 1.25 (1.05–1.49) * | 1.24 (1.04–1.47) * | 1.18 (1.00–1.41) | 1.16 (0.97–1.39) |
≥3 | 1.89 (1.58–2.27) *** | 1.83 (1.53–2.20) *** | 1.71 (1.42–2.05) *** | 1.65 (1.37–1.98) *** |
ADL (vs. Normal) | ||||
Declined | 1.09 (0.95–1.24) | 1.04 (0.90–1.20) | 1.09 (0.95–1.25) | 1.04 (0.90–1.20) |
Midstream Factors | ||||
Smoking (vs. No) | ||||
Yes | 0.89 (0.77–1.04) | 0.87 (0.75–1.02) | ||
Current drinking (vs. No) | ||||
Yes | 0.72 (0.62–0.83) *** | 0.71 (0.61–0.82) *** | ||
Depressive mood (vs. No) | ||||
Yes | 1.08 (0.94–1.24) | 1.09 (0.95–1.26) | ||
Cognitive function score (vs. <10) | ||||
≥10 | 1.01 (0.88–1.15) | 0.95 (0.82–1.09) | ||
Upstream Factors | ||||
Residence location (vs. Urban areas) | ||||
Rural areas | 0.86 (0.75–0.99) * | 0.85 (0.74–0.99) * | ||
Educational level (vs. 0) | ||||
6 years | 0.94 (0.80–1.11) | 0.96 (0.81–1.14) | ||
9 years | 1.06 (0.85–1.33) | 1.09 (0.87–1.37) | ||
≥12 years | 0.84 (0.65–1.08) | 0.88 (0.67–1.14) | ||
Personal income (vs. No) | ||||
Yes | 0.90 (0.79–1.02) | 0.93 (0.81–1.06) | ||
Health education (vs. No) | ||||
Yes | 1.95 (1.72–2.20) *** | 1.97 (1.75–2.24) *** | ||
Hosmer–Lemeshow test | χ2 = 4.02 p = 0.855 | χ2 = 5.21 p = 0.734 | χ2 = 13.37 p = 0.100 | χ2 = 13.74 p = 0.089 |
Variable | Model 1 OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) | Model 4 OR (95% CI) |
---|---|---|---|---|
Downstream Factors | ||||
Sex (vs. Male) | ||||
Female | 0.89 (0.80–0.99) * | 0.86 (0.76–0.97) * | 1.03 (0.92–1.15) | 0.94 (0.83–1.07) |
Age (vs. 45–54) | ||||
55–64 | 1.08 (0.94–1.24) | 1.13 (0.98–1.30) | 1.14 (0.99–1.32) | 1.16 (1.00–1.34) * |
65–74 | 1.18 (1.01–1.36)* | 1.25 (1.08–1.46) ** | 1.28 (1.09–1.49) ** | 1.29 (1.11–1.51) ** |
≥75 | 1.35 (1.13–1.63) ** | 1.45 (1.20–1.75) *** | 1.48 (1.22–1.80) *** | 1.49 (1.22–1.81) *** |
BMI (vs. Normal) | ||||
Underweight | 0.81 (0.58–1.12) | 0.84 (0.61–1.18) | 0.87 (0.62–1.22) | 0.89 (0.64–1.24) |
Overweight | 1.45 (1.28–1.63) *** | 1.36 (1.20–1.53) *** | 1.30 (1.15–1.47) *** | 1.25 (1.11–1.42) *** |
Obese | 1.46 (1.24–1.71) *** | 1.37 (1.16–1.60) *** | 1.32 (1.12–1.56) ** | 1.27 (1.07–1.49) ** |
The number of complications (vs. 0) | ||||
1 | 1.15 (1.00–1.34) | 1.15 (1.00–1.34) | 1.11 (0.95–1.28) | 1.11 (0.96–1.29) |
2 | 1.16 (1.00–1.36) | 1.15 (0.98–1.34) | 1.08 (0.92–1.27) | 1.08 (0.92–1.27) |
≥3 | 1.58 (1.36–1.83) *** | 1.55 (1.33–1.81) *** | 1.38 (1.18–1.61) *** | 1.39 (1.18–1.62) *** |
ADL (vs. Normal) | ||||
Declined | 0.69 (0.61–0.77) *** | 0.76 (0.68–0.86) *** | 0.81 (0.72–0.91) ** | 0.85 (0.75–0.95)** |
Midstream Factors | ||||
Smoking (vs. No) | ||||
Yes | 0.75 (0.66–0.86) *** | 0.76 (0.66–0.87) *** | ||
Sleep duration (vs. 6–8 h) | ||||
<6 h | 0.88 (0.78–0.99) * | 0.87 (0.78–0.99) * | ||
≥9 h | 0.81 (0.67–0.98) * | 0.87 (0.71–1.05) | ||
Depressive mood (vs. No) | ||||
Yes | 0.93 (0.83–1.05) | 0.97 (0.86–1.09) | ||
Cognitive function score (vs. <10) | ||||
≥10 | 1.55 (1.39–1.74) *** | 1.29 (1.14–1.46) *** | ||
Upstream Factors | ||||
Place of residence (vs. Urban areas) | ||||
Rural areas | 0.59 (0.52–0.66) *** | 0.61 (0.54–0.69) *** | ||
Educational level (vs. 0) | ||||
6 years | 1.21 (1.05–1.39) ** | 1.13 (0.98–1.31) | ||
9 years | 1.49 (1.24–1.79) *** | 1.33 (1.09–1.61) ** | ||
≥12 years | 2.27 (1.82–2.83) *** | 1.98 (1.58–2.49) *** | ||
Personal income (vs. No) | ||||
Yes | 1.11 (0.99–1.24) | 1.11 (0.99–1.25) | ||
Health education (vs. No) | ||||
Yes | 1.30 (1.17–1.45) *** | 1.29 (1.16–1.44) *** | ||
Hosmer–Lemeshow test | χ2 = 12.52 p = 0.129 | χ2 = 10.08 p = 0.259 | χ2 = 3.41 p = 0.906 | χ2 = 6.47 p = 0.595 |
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Liu, J.; Yang, Y.; Zhou, J.; Liu, T.; Zhang, W.; Wei, L.; Wu, S. Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study. Int. J. Environ. Res. Public Health 2020, 17, 7341. https://doi.org/10.3390/ijerph17197341
Liu J, Yang Y, Zhou J, Liu T, Zhang W, Wei L, Wu S. Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study. International Journal of Environmental Research and Public Health. 2020; 17(19):7341. https://doi.org/10.3390/ijerph17197341
Chicago/Turabian StyleLiu, Jianjian, Ying Yang, Jiayi Zhou, Tianyu Liu, Wenjie Zhang, Liuyi Wei, and Shaotang Wu. 2020. "Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study" International Journal of Environmental Research and Public Health 17, no. 19: 7341. https://doi.org/10.3390/ijerph17197341