Self-care practices among elderly hypertensive patients living in the Highlands of Vietnam: A cross-sectional study

Background: Hypertension is a growing burden among the elderly, particularly in lowand middle-income countries. Self-care practices are critical for hypertension management but understudied, especially in the Highlands region of Vietnam. Aims: This study aims to assess self-care practices among elderly hypertensive patients in the Highlands region of Vietnam and to determine factors associated with non-adherence. By identifying sociodemographic and clinical predictors of poor self-care adherence, the study seeks to provide insights for targeted interventions to enhance hypertension management in this vulnerable population. Methods: A cross-sectional study was carried out involving 438 hypertensive patients aged 60 and older managed at six commune health centers. Self-care practices were assessed across six HSCALE domains. Data were collected via interviews, medical records, and blood pressure (BP) measurements, with adherence defined as meeting criteria in at least four domains. Multiple logistic regression was used to analyze factors associated with non-adherence. Results: Overall, 85.4% of participants adhered to self-care practices, with domain-specific adherence ranging from 39.5% (weight management) to 96.1% (low-sodium diet). Despite high adherence, only 12.8% achieved normotension. Non-adherence was associated with male sex [Adjusted Odds Ratio (AOR) = 4.73, 95% Confidence Interval (CI): 2.40 – 9.34], illiterate (AOR = 3.08, 95% CI: 1.18 – 8.03), currently working for income (AOR = 2.01, 95% CI: 1.10 – 3.67), isolated systolic hypertension (AOR = 2.34, 95% CI: 1.24 – 4.40), and poor hypertension knowledge (AOR = 4.57, 95% CI: 2.45 – 8.51). Conclusion: This study highlights the importance of comprehensive self-care strategies in hypertension control among the elderly. Despite high overall adherence, the persistence of inadequate BP control underscores the need for more effective weight management and tailored interventions. Findings emphasize the role of health literacy, socioeconomic factors, and clinical characteristics in shaping self-care behaviors, which could inform future policy and community-based hypertension management programs.