The patterns of lifestyle, metabolic status, and obesity among hypertensive patients in Korea: a latent class analysis

Abstract

Objectives This study was conducted to identify latent classes in hypertensive patients based on the clustering of risk factors including lifestyle risk factors, metabolic risk and obesity in each sex. Methods This cross-sectional study included 102,780 male and 103,710 female hypertensive patients that underwent health checkups at 16 centers in Korea, in 2018. It was used a latent class analysis approach to identify subgroups of hypertensive patients. Multivariate logistic regression was performed to examine association latent classes and comorbidities of hypertension. Results Four classes model provided the best fit each sex. Identified latent classes were Class Ⅰ[male 16.9%, famale 1.7%; high risk of lifestyle behaviors (HB) with metabolic disorders E p u b a h e a d o f p r i n t 2 and obesity(MO)], Class Ⅱ[male 32.4%, famale 47.1%; low risk of lifestyle behaviors (LB) with MO], Class Ⅲ[male 15.3%, famale 1.8%; HB with metabolic disorders and normal weight (MNW)], Class Ⅳ[male 35.5%, famale 49.4%; LB with MNW]. The lifestyle patterns in latent classes were divided into high or low risk according to smoking and high risk drinking among male, and had complex patterns in which physical inactivity were alone or combined other factors among female. Individuals with stage 2 hypertension or diabetes were likely to belong to classes including obesity(HB-MO, LB-MO) in both sex, and additionally belong to HB-MNW in male. Conclusions Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesiry. Hypertensive patients need to manage obesity in female and lifestyle risk factors as well as obesity in male, and gender-specific lifestyle behaviors should be considered on controling the hypertension.

Factors and at-risk group associated with hypertension self-management patterns among people with physical disabilities: a latent class analysis

“…On the other hand, contrary to prior studies of people without disabilities using LCA [ 7 , 10 ] a clear distinction in the self-management behaviours among groups was evident in our study. In particular, the classes exhibited stark differences with respect to physical activity (high self-management group; 100.0% vs. inactive behaviour group; 0%), although the overall probability of physical activity was not particularly different compared to previous studies [ 7 , 10 ]. Since inadequate physical activity is a well-known challenge for people with physical disabilities [ 18 ], it is important to define the characteristics and health measures among the groups.…”

“…The present study has identified three mutually exclusive subgroups of hypertension self-management behaviours: a high self-management group, a harmful habitual behaviour group, and an inactive behaviour group, based on five self-management behaviours: smoking, alcohol intake, physical activity, diet, and weight control. Only 40.8% of our respondents showed adherence to the 2018 Hypertension Guidelines in their self-management of hypertension Therefore, our results extend the existing literature observations that a large proportion of patients with hypertension do not perform self-management behaviours well [ 7 , 10 , 17 ]. On the other hand, contrary to prior studies of people without disabilities using LCA [ 7 , 10 ] a clear distinction in the self-management behaviours among groups was evident in our study.…”

“…Only 40.8% of our respondents showed adherence to the 2018 Hypertension Guidelines in their self-management of hypertension Therefore, our results extend the existing literature observations that a large proportion of patients with hypertension do not perform self-management behaviours well [ 7 , 10 , 17 ]. On the other hand, contrary to prior studies of people without disabilities using LCA [ 7 , 10 ] a clear distinction in the self-management behaviours among groups was evident in our study. In particular, the classes exhibited stark differences with respect to physical activity (high self-management group; 100.0% vs. inactive behaviour group; 0%), although the overall probability of physical activity was not particularly different compared to previous studies [ 7 , 10 ].…”

“…This result was in agreement with a previous study that reported frequent substance use, such as cigarettes and alcohol, is often amplified among those who are young, male, and single [ 19 ]. Young men display a greater tendency toward substance use when coping with their problems [ 10 ] and prioritise other goals before taking care of their health [ 20 ]. Conversely, female sex predicted membership in the inactive behaviour group, whose members satisfactorily complied with avoiding harmful habitual behaviours, such as tobacco and alcohol use.…”

“…Despite the clear benefits of self-management behaviours, many hypertensive patients do not comply with the suggested recommendations, thereby failing to regulate their blood pressure. Self-management may be even more challenging for those with physical disabilities due to their complex needs, such as physical restrictions and co-morbid health conditions, thus highlighting the need for extra support and appropriate accommodations [ 10 ]. Providing safe, appropriate, and accessible options for people with disabilities requires support across many sectors to help them engage more easily in essential healthy behaviours [ 11 ].…”