Psycho-behavioral predictors of uncontrolled blood pressure: A case-control study

Background: We aimed to determine the role of demographic, lifestyle, and personality trait factors in predicting control of blood pressure (BP) among patients with hypertension (HTN) in West Azerbaijan, Iran.

Methods: In this case control study we recruited participants from all primary health centers of Salmas city; who were at least 18 years of age, had a HTN diagnosis during the previous six months, and had a mandatory household record. Of 490 random subjects approached, 441 (84.2%) fulfilled our inclusion criteria (case: 221; control: 220). The age-matched controls were recruited from the same source population and were required to have controlled HTN. Data were collected through demographic Checklist, Ten-Item Personality Inventory (TIPI) and International Physical Activity Questionnaire (IPAQ).

Results: Upon multivariate analyses, factors related to personality traits subdomains including extraversion personality (odd ratio [OR]: 0.85; CI: 0.73, 0.97) was effective in control of BP. Factors related to uncontrolled BP were agreement and consciences subdomains (OR 1.26 [CI: 1.07, 1.48] and OR 1.21 [CI: 1. 02, 1.44]), rare fruit consumption (OR 5.95 [CI: 1.24, 12.1]), Grade 1 and 2 obesities (OR 2.29 [CI: 1.28, 4.09] and OR 7.11 [CI: 2.21, 12.52]) and smoking (OR 3.27 [CI: 1.56, 6.89]).

Conclusion: In addition to regular physical activity and fruit consumption and quitting smoking; personality traits such as Agreement and conscience personality traits were predictive of HTN control. We believe our work provides the required knowledge to design comprehensive HTN prevention programs by taking into account the multi-level causality approach.