Key result
Male gender linked to ~53% higher odds of an unhealthy lifestyle in older hypertensive adults.
Why the study?
Self-management and lifestyle modifications are emphasized to reduce the cardiovascular burden of hypertension in older adults, but adherence to lifestyle recommendations and risk factor control needed evaluation.
Cross-Sectional (n=10,162)
Effect estimate: OR 1.53 (95% CI 1.09-2.17)
p-value: p=0.02
Adherence to physical activity, healthy diet, and control of central obesity remain suboptimal among older US adults with hypertension, highlighting the need for targeted lifestyle interventions.
Suboptimal lifestyle adherence in older hypertensives, especially men and non-Hispanic Blacks, warrants targeted assessment; hypothesis-generating for prospective intervention trials.
BACKGROUND: Self-management of hypertension is particularly emphasized for older patients. Specifically, it is critical that initiatives regarding lifestyle modifications be applied to reduce the cardiovascular burden of hypertension among the elderly population. METHODS: We included participants aged 65 years or older with hypertension from the National Health and Nutrition Examination Survey (NHANES) years 1999-2018 to analyze the adherence to lifestyle recommendations and the control of cardiovascular risk factors. Recommended lifestyle behaviors and targets for cardiovascular risk factor controls were defined according to the clinical guidelines for the management of hypertension. Logistic regression analyses were utilized to identify factors associated with nonadherence. RESULTS: Of 10,162 participants (mean age, 74.45 years) included, 4350 (42.81%) had controlled blood pressure. Adherence to healthy lifestyle behaviors varied among respondents. Smoking cessation (88.82%) and alcohol reduction (74.11%) were relatively high, whereas adherence to physical activity (14.57%), low salt diet (36.81%), and fiber intake (12.87%) were significantly lower. A significant proportion of respondents achieved target levels for LDL-C (76.00%) and HbA1c (72.49%), whereas fewer participants met BMI (25.02%) and waist circumference (31.26%) goals for cardiovascular risk factor control. After multivariable adjustment, male gender (OR: 1.53 [1.09-2.17]), non-Hispanic black race (OR: 1.85 [1.06-3.24]), metabolic syndrome status (no vs. yes, OR: 0.67 [0.47-0.94]), and chronic kidney disease status (no vs. yes, OR: 0.63 [0.41-0.97]) were associated with increased odds of unhealthy lifestyle, whereas male gender (OR: 1.37 [1.04-1.80]), high socioeconomic status (OR: 1.61 [1.05-2.49]), metabolic syndrome status (no vs. yes, OR: 0.03 [0.02-0.04]), and diabetes mellitus status (no vs. yes, OR: 0.68 [0.49-0.96]) were associated with increased odds of uncontrolled cardiovascular risk. CONCLUSIONS: Adherence to physical activity and healthy diet, and control of central obesity are suboptimal among older patients with hypertension. The etiology of nonadherence is multifactorial and includes causes associated with sociodemographic status, and comorbidities.
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Tang et al. (2025) conducted a cross-sectional in Hypertension (n=10,162). Lifestyle modifications was evaluated on Unhealthy lifestyle (>2 lifestyle behaviors not following recommendations) associated with male gender (OR 1.53, 95% CI 1.09-2.17, p=0.02). Among older adults with hypertension, adherence to physical activity, low salt diet, and fiber intake was low, with male gender (OR 1.53) and non-Hispanic Black race (OR 1.85) increasing the odds of an unhealthy lifestyle.
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