Spatial heterogeneity of blood pressure control and its influencing factors in elderly patients with essential hypertension: A small-scale spatial analysis

IF 4.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health & Place Pub Date : 2025-02-20 DOI:10.1016/j.healthplace.2025.103428
Jingming Wei , Yudong Miao , Jingbao Zhang , Jian Wu , Zhanlei Shen , Junwen Bai , Dongfang Zhu , Ruizhe Ren , Xinran Li , Mingyue Zhen , Jiajia Zhang , Jinxin Cui , Dan Guo , Wenyong Dong , Clifford Silver Tarimo , Qiuping Zhao , Rongmei Liu , Jianping Hu , Miaojun Li
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Abstract

Background

The blood pressure control status and its influencing factors in elderly patients with essential hypertension are complex. Existing studies often overlook spatial differences or utilize coarse spatial scales, which limits the understanding of the fine patterns of spatial heterogeneity and the design and implementation of further prevention and control policies.

Methods

In August 2023, A community-based survey was carried out in Jia County, China, involving a total of 19080 patients over 65 years old. Traditional linear regression and multi-scale geographically weighted regression were used to analyze the influencing factors and their spatial heterogeneity.

Results

Low blood pressure control rate was concentrated in the central urban communities, characterized by a significant low-low cluster, while high blood pressure control rate was concentrated in some northwest and southeast rural communities, with a prominent high-high cluster. There was spatial heterogeneity in the influencing factors. For example, obesity was significantly negatively correlated with blood pressure control rate in central urban communities, while physical activity exhibited a positive correlation in northwest and southeast rural communities.

Conclusion

This underscores the need to implement hypertension management services according to local conditions in terms of strengthening the weight management of patients in urban communities and the guidance of physical activity in rural communities. The government should increase financial investment in medical and health care in rural communities and reduce the burden of health costs. This study proves that the geospatial approach can provide objective scientific data support for public health policy innovation.
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老年原发性高血压患者血压控制的空间异质性及其影响因素:一项小尺度空间分析
背景老年原发性高血压患者血压控制状况及其影响因素较为复杂。现有研究往往忽视空间差异或采用粗糙的空间尺度,限制了对空间异质性精细格局的认识和进一步防控政策的设计与实施。方法于2023年8月在中国嘉县开展社区调查,共纳入65岁以上患者19080例。采用传统线性回归和多尺度地理加权回归分析影响因素及其空间异质性。结果低血压控制率集中在中心城区,呈明显的低-低聚集型;高血压控制率集中在西北部和东南部部分农村社区,呈显著的高-高聚集型。影响因素存在空间异质性。例如,在中心城市社区,肥胖与血压控制率呈显著负相关,而在西北和东南部农村社区,体育活动与血压控制率呈显著正相关。结论应因地制宜地开展高血压管理服务,加强城市社区患者的体重管理,加强农村社区患者的身体活动指导。政府应加大对农村社区医疗卫生的财政投入,减轻卫生费用负担。研究结果表明,地理空间方法可为公共卫生政策创新提供客观科学的数据支持。
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来源期刊
Health & Place
Health & Place PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.70
自引率
6.20%
发文量
176
审稿时长
29 days
期刊介绍: he journal is an interdisciplinary journal dedicated to the study of all aspects of health and health care in which place or location matters.
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