Abstract: Background The control of hypertension is still unsatisfactory, the number of patients continues to increase in China, and elf-management plays a positive role in the prevention of relevant complications and reduces the economic burden of the disease. The influencing factors of prevalence and self-management are varied, but there is a shortage of studies to identify the path coefficients and the indirect effects between factors. Objective The aim of this study was to analyze the prevalence of hypertension and self-management and their influencing factors in rural Dayao County of Yunnan Province. Methods The multi-stage stratified random sampling method was used to select 2 499 rural residents≥35 years from Dayao County. Each participant received questionnaire survey and physical examination. Principal component analysis was used to construct the index of socioeconomic position (SEP), while structural equation modelling (SEM) was used to analysis the possible influencing factors of prevalence of hypertension and self-management. Results Among the surveyed population, the prevalence of hypertension was 53.7%, and the rate of compliance to anti-hypertensive drugs, self-monitoring of blood pressure and taking measures to control hypertension was 84.5%, 82.0% and 88.3%, and was 52.4%, 82.2%, 80.8% and 87.8% for males and 55.0%, 86.8%, 83.2% and 88.0% for females, respectively. The result of SEM indicated that the following associated factors had a direct statistically significant effect on prevalence of hypertension: SEP (-0.43), body shape (including overweight or obesity and central obesity) (0.16), physical inactivity (0.06), and family history of hypertension (0.15), whereasgender (0.228) through SEP, and age (0.348) through SEP and physical inactivity had only an indirect effect on prevalence of hypertension. Similarly, the results also indicated that SEP (0.20), alcohol consumption (-0.17), and conditions of hypertensive patients (including the course of disease and complications) (0.53) had a direct statistically significant effect on prevalence of self-management, while gender (0.06) had an indirect effect on prevalence of self-management through alcohol consumption. Conclusion There is a relatively high prevalence of hypertension and an overall high level of self-management in rural Dayao County. Future health education and management regarding hypertension should be strengthened for the elderly and individuals with low SEP and unhealthy lifestyles.

Key words: Hypertension, Prevalence, Self-Management, Influencing factors, Structural equation modeling

摘要： 背景　我国高血压控制情况仍不理想，患者数持续增加，自我管理有助于预防相关并发症，减轻疾病负担，高血压患病和自我管理的影响因素复杂多样，但目前缺乏明确各因素间路径大小及间接作用的研究。目的　分析云南省大姚县农村居民高血压患病和自我管理现状及其影响因素。方法　采用多阶段分层随机抽样方法从大姚县抽取2 499名 ≥35岁常住居民进行问卷调查和体格检查，采用主成分分析法（Principal Component Analysis, PCA）构建调查对象的社会经济地位（Socioeconomic Position, SEP），采用结构方程模型（Structural equation modeling, SEM）分析高血压患病和自我管理的影响因素。结果　云南省大姚县高血压患病率、遵医嘱服药率、自我监测血压率和采取降压措施率分别为53.7%、84.5%、82.0%和88.3%，其中男性分别为52.4%、82.2%、80.8%和87.8%，女性分别为55.0%、86.8%、83.2%和88.0%。SEM结果显示，SEP、体型（包括超重或肥胖和中心性肥胖）、缺乏体力活动以及高血压家族史对高血压患病产生直接作用，路径系数分别为-0.43、0.16、0.06和0.15；性别通过SEP、年龄通过SEP和缺乏体力活动对高血压患病产生间接作用，路径系数分别为0.228和0.348；SEP、有饮酒行为以及高血压患者的病情（包括患病年限和并发症）对自我管理产生直接作用，路径系数为0.20、-0.17和0.53；性别通过饮酒行为对高血压自我管理产生间接作用，路径系数为0.06。结论　大姚县高血压患病率较高，自我管理情况总体较好。应加强老年人、低社会经济地位和不良生活方式者的高血压健康教育和健康管理工作。

关键词: 高血压, 患病率, 自我管理, 影响因素, 结构方程模型