The control of hypertension is still unsatisfactory, as the number of patients continues to increase in China, and self-management plays a positive role in the prevention of relevant complications and reducing the economic burden of the disease. The influencing factors of prevalence and self-management are varied, but few studies have identified path coefficients and indirect effects between factors.

The aim of this study was to analyse the prevalence of hypertension and self-management and their influencing factors in rural Dayao County, Yunnan Province.

A multistage stratified random sampling method was used to select 2 499 rural residents aged≥35 years from Dayao County. Each participant received a questionnaire survey and underwent physical examination. Principal component analysis was used to construct the index of socioeconomic position (SEP) , whereas structural equation modelling (SEM) was used to analysis the possible influencing factors of the prevalence of hypertension and self-management.

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 88.8% for females, respectively. The prevalence of hypertension increased with age (χ²_trend=224.142, P<0.001), whereas the rate of self-monitoring of blood pressure decreased (χ²_trend=4.012, P<0.05). A greater prevalence of hypertension was observed in those with lower education levels and SEP (χ²=28.036, χ²_trend=12.147, P<0.001) . Individuals with good access to medical services had a higher rate of self-monitoring of blood pressure than their counterparts did (χ²=10.137, P<0.05) . The result of SEM indicated that the following factors had a direct statistically significant effect on the prevalence of hypertension: SEP (-0.43) , body shape (including overweight or obesity and central obesity status) (0.16) , physical inactivity (0.06) , and family history of hypertension (0.15) . However indirect effects on the prevalence of hypertension were observed for sex (0.23, through SEP) and age (0.35, through SEP and physical inactivity) . 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 statistically significant direct effect on the prevalence of self-management, while gender (0.06) had an indirect effect on prevalence of self-management through alcohol consumption.

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.