Abstract
OBJECTIVESThis study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex.METHODSThis cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension.RESULTSA four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male.CONCLUSIONSMetabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.
Highlights
This cross-sectional study included hypertensive patients aged > 40 years who visited 16 health check-up centers in 13 regions of Korea from January 2018 to December 2018. This study included those who were diagnosed with HTN, were taking anti-hypertensive drugs at the interview, or had a systolic blood pressure (SBP) of > 140 mmHg/a diastolic blood pressure (DBP) of > 90 mmHg [15]
To identify mutually exclusive patterns in hypertensive patients, latent classes based on lifestyle, metabolic abnormalities, and obesity were analyzed, and four latent classes were distinguished for each sex
Metabolic abnormalities were included in all classes, and four classes were designated as follows: HB-MO, lifestyle behaviors with metabolic disorders and obesity (LB-MO), HBMNW, and the LB-MNW
Summary
According to the World Health Organization (WHO), the prevalence of hypertension (HTN) worldwide is 25% in male and 20%. Management of BP by lifestyle improvement is recommended and as a supplementary treatment method for the early treatment of hypertensive patients [4]. In intervention studies on stage 1 hypertensive patients, reduction in mean BP and management of HTN were confirmed after lifestyle improvements, in line with other similar studies [4,5,6].
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