Medication Taking, Salt Reduction And Exercise Are Beneficial For Hypertensive Patients' Blood Pressure Control: Application Of Transtheoretical Model In A Cross-Sectional Study

Objectives: To determine if stages of Transtheoretical Model (TTM) have an impact on hypertensive patients’ blood pressure control and to identify the factors influencing people's choices over stages of TTM. This study was funded by the Natural Science Foundation of Beijing (Grant No. 7162105). Methods: A total of 7019 adults in Daxing District, Beijing were recruited with PPS sampling and 2077 had hypertension. Questionnaire survey collected patients’ choices of TTM stages in medication taking, salt reduction and exercise. Oneway ANOVA was used to determine if stages of TTM had an impact on blood pressure and generalized ordinal logistic model (gologit) was used to identify the influencing factors of patients’ choices over TTM. Results: Oneway ANOVA indicated that patients in AM stage had significantly lower blood pressure than those in PC and CP stages. Factors included in gologit regression were age, sex, education, duration of hypertension, insurance and presence of other chronic diseases. Results of Wald test indicated that all of the three models did not violate parallel lines assumption. The model for salt reduction revealed that male tended to have lower stages of TTM (OR:0.71, 95%CI: [0.54, 0.92], P = 0.010) and compared with junior high education, patients with high school education tended to choose higher stages of TTM (OR:1.66, 95%CI: [1.21, 2.26], P = 0.002). The model for exercise also indicated a positive influence of high school education over junior high (OR:1.40, 95%CI: [1.02, 1.91], P = 0.036). The model for medication taking indicated that age had a positive influence on people's choices (OR:1.04, 95%CI: [1.02, 1.05], P < 0.001). Conclusion: Stages of TTM significantly influence hypertensive patients’ blood pressure. Age and education are key factors influencing their choices on TTM stage.