Spatial heterogeneity of blood pressure control and its influencing factors in elderly patients with essential hypertension: A small-scale spatial analysis

Background: The blood pressure control status and its influencing factors in elderly patients with essential hypertension are complex. Existing studies often overlook spatial differences or utilize coarse spatial scales, which limits the understanding of the fine patterns of spatial heterogeneity and the design and implementation of further prevention and control policies. Methods: In August 2023, A community-based survey was carried out in Jia County, China, involving a total of 19080 patients over 65 years old. Traditional linear regression and multi-scale geographically weighted regression were used to analyze the influencing factors and their spatial heterogeneity. Results: Low blood pressure control rate was concentrated in the central urban communities, characterized by a significant low-low cluster, while high blood pressure control rate was concentrated in some northwest and southeast rural communities, with a prominent high-high cluster. There was spatial heterogeneity in the influencing factors. For example, obesity was significantly negatively correlated with blood pressure control rate in central urban communities, while physical activity exhibited a positive correlation in northwest and southeast rural communities. Conclusion: This underscores the need to implement hypertension management services according to local conditions in terms of strengthening the weight management of patients in urban communities and the guidance of physical activity in rural communities. The government should increase financial investment in medical and health care in rural communities and reduce the burden of health costs. This study proves that the geospatial approach can provide objective scientific data support for public health policy innovation.