Key result
Low perceived social support linked to ~6-fold higher odds of poor hypertension treatment adherence.
Why the study?
Middle-aged and older adults with hypertension in rural China face elevated risk of poor adherence amid healthcare disparities and limited primary care support.
What factors are associated with poor hypertension treatment adherence among middle-aged and older adults in rural China?
Case-Control (n=287)
No
What factors are associated with poor hypertension treatment adherence among middle-aged and older adults in rural China?
Odds Ratio: 6.11 (95% CI 2.42–13.67)
p-value: p=<0.001
Poor hypertension treatment adherence in rural China is strongly associated with employment, polypharmacy, multimorbidity, low health literacy, and poor psychosocial support.
Should not alter practice in rural hypertension care; extends observational data on social support, hypothesis-generating for interventions.
BACKGROUND: Treatment adherence is a major challenge in hypertension management, particularly given the growing aging issue and burden of chronic diseases in China. Middle-aged and older adults with hypertension in rural China face a greater risk of poor adherence because of health care disparities and limited primary care support. This study aimed to determine the factors associated with treatment adherence among middle-aged and older adults with hypertension in rural China. METHODS: A hospital-based case–control study was conducted to gather information among hypertensive patients in Daqiao Town, China. Treatment adherence was assessed using the Hill-Bone Compliance to High Blood Pressure Therapy (HBCHBPT) scale, with cases defined as patients with poor adherence (score < 48) and controls defined as those with good adherence (score ≥ 48). Data were collected using a structured questionnaire, and stepwise logistic regression was used to identify factors associated with poor adherence. RESULTS: A total of 287 patients with hypertension (96 cases and 191 controls) were included. Overall, 56.1% were aged 40–65 years, 48.4% were male, and 54.7% were employed. Poor antihypertensive treatment adherence was significantly associated with being employed (AOR = 4.15, 95% CI = 1.63–10.56), taking ≥ 3 medicines (AOR = 3.67, 95% CI = 1.45–9.30), having ≥ 3 other chronic diseases (AOR = 2.66, 95% CI = 1.18–5.99), infrequent blood pressure measurement (AOR = 3.41, 95% CI = 1.00–11.66), attending follow-up with companions or alone (AOR = 9.79, 95% CI = 4.01–23.90), poor self-rated blood pressure control (AOR = 3.32, 95% CI = 1.12–9.78), insufficient health literacy (AOR = 5.84, 95% CI = 2.60–13.08), low self-efficacy (AOR = 6.11, 95% CI = 2.54–14.67), and low perceived social support (AOR = 6.11, 95% CI = 2.42–13.67). CONCLUSION: Poor adherence reflects the combined effects of treatment complexity, primary health care, and psychosocial factors. Blood pressure monitoring, village doctor home visits, chronic disease management, self-rated blood pressure assessment, and targeted health education with psychosocial support would help to improve long-term adherence. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27412-2.
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Kang et al. (2026) conducted a case-control in Hypertension (n=287). Low perceived social support vs. Medium-to-high perceived social support was evaluated on Poor antihypertensive treatment adherence (HBCHBPT score < 48) (AOR 6.11, 95% CI 2.42-13.67, p=<0.001). Low perceived social support was significantly associated with poor hypertension treatment adherence (AOR 6.11) among middle-aged and older adults in rural China, alongside other social determinants.
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