Prediction Model for Non-pharmacological Treatment Implement of Hypertension based on Residential Area
Abstract
This study aimed to construct a predictive model for the nonpharmacological treatment of hypertension according to residential area using the 2021 Community Health Survey (CHS). This cross-sectional study analyzed the data of 48,662 individuals diagnosed with hypertension. A decision tree analysis was conducted to create a predictive model. A split-sample test was conducted to verify the accuracy of the final model. Multiple logistic regression analysis was conducted to identify the factors related to the implementation of nonpharmacological treatment. The prediction model identified that subjects who lived in a “rural” area, did not complete hypertension management education, and did not respond to the written health information literacy question showed the lowest probability of performing nonpharmacological treatment at 10.2%. Conversely, those who lived in a “city”, had completed hypertension education, and had above-average life satisfaction were most likely to implement the program (45.0%). Multiple logistic regression results showed that those who live in a city, have a good subjective health level, quit smoking, a high level of understanding of written health information, participate in hypertension management education, engage in economic activities, and have a high level of education or of life satisfaction had a high possibility of implementing nonpharmacological treatment of hypertension. Providing customized hypertension management education by identifying education levels of individuals with hypertension and ensuring their comprehension of written medical information will be effective in improving the rate of nonpharmacological treatment of hypertension.
References
Ahn, Y. (2018). Compliance level with therapeutic regimen of medication and life style among patients with hypertension in rural communities. J Korean Acad Public Heal Nurs, 21(2), 125–133.
Bae, S., Kim, J., Min, K., Kwon, S., & Han, D. (1999). Patient compliance and associated factors in the community-based hypertension control program. Journal of Preventive Medicine and Public Health, 32(2), 215–227.
Baker, D., Wolf, M., Feinglass, J., Thompason, J., Gazmarian, J., & Ja, H. (2007). Health literacy and mortality among elderly person. Archives of Internal Medicine, 167(14), 1503–1509.
Bracale, R., & Vaccaro, C. (2020). Changes in food chronic following restrictive measures due to COVID-19. Nutrition, Metabolism, and Cardiovascular diseases, 30(9), 1423–1426. https://doi.org/10.1016/j.numecd.2020.05.027
CDC. (2016). Body Mass Index (BMI). Available from https://www.cdc.gov/healthyweight/assessing/bmi/index.html
Choi, J., & Seo, D. (1999). Decision Trees and Its Applications. Journal of the Korean Statistical Society, 4(1), 61–83.
Choi, J., Han, H., Kang, H., & Kim Y. (1998). Data mining decision tree by using answer Tree. Seoul.
Chun, B., & Shin, J. (2011). The scientific evidence for the management of prehypertensives and high risk group. Journal of the Korean Medical Association, 54(10), 1013–1019. https://doi.org/10.5124/jkma.2011.54.10.1013
Eum, S., & Lee, I. (2013). The health care status and healthy life practices of hypertensive patients. Perspective in Nursing Science, 10(1), 32–40.
GBD 2019 Risk Factors Collaborators. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396(10258), 123-1249. https://doi.org/10.1016/S0140-6736(20)30752-2.
Joo, J., & You, M. (2018). The attribute of multiple chronic diseases experience of frequent medical overusers in rural area. Korean J Public Heal, 55(2), 41–53.
Jung, M., & Kim J. (2022). Influence of social capital on depression of older adults living in a rural area: a cross-sectional study using the 2019 Korea Community Health Survey. Journal of Korean Academy of Nursing, 52(2),144–56.
Jung, S.Y., & Moon, K.J. (2023). Factors affecting self-care among community-dwelling hypertensive older adults: A cross-sectional study. Nursing Open, 10(6), 3892–3905. https://doi.org/10.1002/nop2.1647
Jurak, G., Morrison, S., Leskosek, B., Kovac, M., Hadzic, V., & Vodicar J. (2020). Physical activity recommendations during the coronavirus disease-2019 virus outbreak. Journal of Sport and Health Science, 9(4), 325–327. https://doi.org/10.1016/j.jshs.2020.05.003
Kim, K. I., Ji, E.J., & Choi, J.Y. et al. (2021). Ten-year trends of hypertension treatment and control rate in Korea. Scientific Reports, 11(1), 6966. https://doi.org/10.1038/s41598-021-86199-x
Kim, K., & Kim, K. (2010). A prediction model for Internet game addiction in adolescents: using a decision tree analysis. Journal of Korean Academy of Nursing, 40(3), 378–88.
Ko, I., Kim, G., Lim, M., Lee, K., Lee, T., & Park, H.(2007). Effects of health education on the knowledge and self-care of hypertension of visiting nursing clients. Journal of Korean Public Health Nursing, 21(2), 134–45.
Konland, K.D.,& Shin, J.H. (2023). Determinants of self-care and home-based management of hypertension: an integrative review. Global Heart, 18(1), 16. https://doi.org/10.5334/gh.1190
Korea Disease Control and Prevention Agency. (2022). Community Health Survey, 2021 [Internet]. Cheongju. Available from: https://chs.kdca.go.kr/chs/mnl/mnlBoardMain.do
Lamirault G, Artifoni M, Daniel et al. (2020). Resistant hypertension: novel insights. Current Hypertension Reviews, 16(1), 61–72. https://doi.org/10.2174/1573402115666191011111402
Lee, H., Kim, Y., Lee, C., Shin, J., Kim, M., & Choi, B. (2011). Awareness, treatment and control of hypertension and related factors in the jurisdictional areas of primary health care posts in a rural community of Korea. Journal of Preventive Medicine & Public Health, 4(2), 74–83. https://doi.org/10.3961/jpmph.2011.44.2.74
Lim, S. (2022). Korea Hypertension Fact Sheet 2022. The Korean Society of Hypertension. Available from: https://www.koreanhypertension.org/reference/guide?mode=read&idno=10079
Ministry of Health and Welfare. (2021). Social distancing extended by 4 weeks(4th level in the metropolitan area, 3rd level in the non-metropolitan area). Ministry of Health and Welfare. Available from https://www.mohw.go.kr/gallery.es?mid=a10505000000&bid=0003&tag=&act=view&list_no=367787
Moon, J.Y., Shin, J. Y., & Kim, J.H. (2021). Cost of illness of chronic disease by region in Korea. Health Policy and Management, 31(1), 65–73. https://doi.org/10.4332/KJHPA.2021.31.1.65
Nakarmi, C.S., Uprety, S., & Ghimire et al. (2023). Factors associated with self-care behaviours among people with hypertension residing in Kathmandu: a cross-sectional study. BMJ Open, 13(6), e070244. https://doi.org/10.1136/bmjopen-2022-070244
Nascimento, M.O., de Oliveira Belo, R.M., de Santana Araújo et al. (2021). Factors associated to the adherence to the non-pharmachological treatment of hypertension in primary health care. Revista Brasileira de Enfermagem, 74(6), e20200173. https://doi.org/10.1590/0034-7167-2020-0173
NCD Risk Factor Collaboration (NCD-RisC). (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 398(10304), 957–980. https://doi.org/10.1016/S0140-6736(21)01330-1
Oh, J., & Park, E. (2017). The impact of health literacy on self-care behaviors among hypertensive elderly. Korean Journal of Health Education and Promotion, 34(1), 35-45. https://doi.org/10.14367/kjhep.2017.34.1.35
Seo, J., & Kim M. A. (2019). Prediction Model of Factors related to Career Maturity in Korean High School Students. Child Health Nursing Research, 25(2), 95–102. https://doi.org/10.4094/chnr.2019.25.2.95
Seo, J., & Kim, M. (2021). A Prediction Model for Quality of Life by Resilience in Disaster Female Victims. Korean Journal of Adult Nursing, 33(6), 639–648. http://dx.doi.org/10.7475/kjan.2021.33.6.639
Sim, J., Go, D., & Yoo, Y. (2007).The effect of an obesity control program and body composition and blood lipid level among middle-aged obese women in a health center. Research in Community and Public Health Nursing, 18(2), 201–210.
Son, O., & Yoo, W.(2004). Effect of health education method for Korean patient with essential hypertension on their compliance with health behaviors. Journal of Korean Society for Health Promotion, 21(2), 215–231.
Sorensen, K., Van den Brouchek, S., Pelikan, J., Fullam, J., & Doyle, G. (2013). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13(948). https://doi.org/10.1186/1471-2458-13-948
Statistics Korea. (2023a). Changes in aerobic physical activity practice rate. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=177&tblId=DT_11702_N236&conn_path=I2
Statistics Korea. (2023b). Changes in healthy eating practices: gender, elementary school students and above. [cited 2023 July 27]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=177&tblId=DT_11702_N231&conn_path=I2
Statistics Korea. (2023c). Trends in the prevalence of hypertension. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=177&tblId=DT_11702_N105&conn_path=I2
Valenzuela, P.L., Carrera-Bastos, P., & Gálvez et al. (2021). Lifestyle interventions for the prevention and treatment of hypertension. Nature Reviews Cardiology, 18(4), 251–275. https://doi.org/10.1038/s41569-020-00437-9
Vancini, R., Andrade, M., Viana, R., Nikolaidis, P., Knechtle, B. & Campanharo, C. et al. (2021). Physical exercise and COVID-19 pandemic in PubMed: Two months of dynamics and one year of original scientific production. Sport Medicine and Health Science, 3(2), 80–92. https://doi.org/10.1016/j.smhs.2021.04.004
Whelton, P.K., Carey, RM., Aronow et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(19), 127–248. https://doi.org/10.1161/HYP.0000000000000065
WHO. (2023b). WHO global report on sodium intake reduction. World Health Organization. Available from : https://www.who.int/publications/i/item/9789240069985
William, B., Poulter, N. & Brown, M. J. et al. (2004). Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. Journal of Human Hypertension, 18, 139–185. https://doi.org/10.1038/sj.jhh.1001683
World Health Organization (WHO). (2023a). Hypertension. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension
Yu, Y.J., Huh, Y., & Sung,W. S. (2023). Comparison of health behaviors between adults with hypertension in single- and multi-person households: based on the 8th Korea National Health and Nutrition Examination Survey. Korean Journal of Health Promotion, 23(1), 1–7. http://dx.doi.org/10.15384/kjhp.2023.23.1.1
Zhang, X.N., Qiu, C., Zheng, Y.Z., Zang, X.Y., & Zhao, Y. (2020). Self-management among elderly patients with hypertension and its association with individual and social environmental factors in China. Journal of Cardiovascular Nursing, 35(1), 45–53. https://doi.org/10.1097/jcn.0000000000000608
