Factors influencing Adoption of Self-Monitoring of Blood Pressure among Hypertensive Patients in Primary Healthcare in Vietnam: A cross-sectional facility-based study

Factors influencing Adoption of Self-Monitoring of Blood Pressure among Hypertensive Patients in Primary Healthcare in Vietnam: A cross-sectional facility-based study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors influencing Adoption of Self-Monitoring of Blood Pressure among Hypertensive Patients in Primary Healthcare in Vietnam: A cross-sectional facility-based study Giang Nguyen Hoang, Lan Nguyen Thi Phuong, Anh Le Thi Kim, Dominika Plancikova, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6210921/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 May, 2025 Read the published version in BMC Primary Care → Version 1 posted 10 You are reading this latest preprint version Abstract Background Hypertension is an increasing health problem in low- and middle-income countries (LMICs) such as Vietnam. Self-monitoring of blood pressure (SMBP) is a crucial component of hypertension management in primary healthcare (PHC) and stimulated by healthcare providers. Yet, its adoption remains suboptimal. This study examines the application and contributing factors to adoption of SMBP among hypertensive patients in a PHC setting in Vietnam. Methods A cross-sectional study was conducted among 989 hypertensive patients managed at commune health stations (CHSs), part of PHC, in two provinces in Vietnam. Data were collected through structured interviews and analysed using descriptive statistics and multivariate logistic regression to identify factors contributing to SMBP practices. Results The prevalence of SMBP among hypertensive patients was 43.1%. Among those who practiced SMBP, 42.3% monitored their blood pressure daily, while 57.7% measured it at least weekly. The majority (80.2%) used home sphygmomanometers, 12% relied on friends or relatives with BP monitoring devices, 7.8% went to a pharmacy of health worker’s home to measure BP. Multivariate analysis identified key factors associated with SMBP adoption. Higher educated persons were more engaged in SMBP (p < 0.001). Pensioners were more likely to engage in SMBP than unemployed individuals (OR = 2.2; p < 0.001). Higher knowledge of hypertension management (OR = 1.10; p < 0.001) and regular physical activity (OR = 1.54; p = 0.005) were also positively associated with SMBP practice. Persons living in Ninh Bing were also more likely to apply SMBP (OR = 1.58; p < 0.001). Conclusion Less than half of hypertensive patients practiced SMBP, highlighting a need for targeted interventions to promote self-monitoring. Key facilitators include better health knowledge, socioeconomic stability, and local healthcare service availability. Strategies to improve SMBP adoption should focus on increasing patient education, ensuring the affordability of BP monitoring devices, and strengthening the role of primary healthcare providers in coaching patients on SMBP. A patient-centred, community-based approach is necessary to enhance hypertension self-management and improve overall cardiovascular health outcomes in Vietnam. self-monitoring of blood pressure hypertension primary healthcare Vietnam chronic disease management self-care practices INTRODUCTION Hypertension is the single most important risk factor for premature death worldwide, as it is a severe chronic condition that greatly elevates the risk of heart, brain, kidney, and other diseases [ 1 ]. Hypertension is annually accounting for 235 million disability adjusted life years lost (DALY) and 10.8 million deaths [ 2 , 3 ]. The prevalence of hypertension has increased dramatically in recent decades [ 3 ]. About 78% of adults with hypertension is living in low- and middle-income countries [ 4 ]. Despite effective prevention and treatment options, hypertension remains underdiagnosed, undertreated, and under-controlled in many countries [ 3 ]. Globally, among adults aged 30–79 years with hypertension, only 54% has been diagnosed, 42% is receiving treatment, and 21% has the hypertension under control [ 5 ]. Evidence shows that a low treatment adherence among patients with hypertension is significantly associated with several adverse cardiovascular outcomes [ 6 – 8 ]. In Vietnam, non-communicable diseases (NCDs) have become the main cause of morbidity and mortality, with cardiovascular diseases being the primary contributor responsible for 42% of deaths and contributing 17% of the total DALYs related to NCDs [ 9 ]. Hypertension, one of the most common chronic NCDs, affects over 26.2% of the adult population in the country. However, only 24.7% of people with hypertension were being managed at health facilities, and just one third of hypertensive patients on anti-hypertensive medication had their blood pressure under control in 2021 [ 10 ]. The best way to prevent stroke and heart disease is by managing high blood pressure effectively [ 3 ]. Self-monitoring and self-management of blood pressure can be successful in lowering blood pressure levels in patients with hypertension [ 11 ]. Extensive evidence suggests that self-monitoring of blood pressure (SMBP) is associated with a reduction of systolic blood pressure among patients with hypertension compared to periodical measurement in medical settings [ 12 , 13 ]. As SMBP offers advantages over clinic measurements, several international hypertension guidelines endorse SMBP [ 14 , 15 ]. It allows for multiple readings over time and in the patient's usual environment, producing a more reliable blood pressure value that is not influenced by the “white coat” or placebo effects [ 16 ]. Extensive evidence indicates that SMBP is associated with significant reduction in blood pressure and improved hypertension control, with the greatest benefits observed when combined with other interventions[ 14 , 17 ]. Incorporating SMBP alongside clinical-setting BP measurement has been shown to be cost-effective compared to clinical BP monitoring alone or standard care for individuals with hypertension. SMBP fosters patients’ involvement in their care and promotes treatment adherence [ 14 , 17 , 18 ]. According to a systematic review with meta-analysis, SMBP has been found to have positive effects on patients with hypertension-related comorbidities as well as those with specific conditions such as obesity [ 17 ]. Previous studies have found several factors influencing adoption of SMBP among patients with hypertension. These include age, gender, education level, income, perceived health status, presence of comorbidities, use of antihypertensive medication, access to healthcare, and social support [ 19 ]. Other factors such as patients' beliefs about the importance of self-monitoring and their confidence in their ability to perform the task may also play a role [ 20 ]. Additionally, factors such as the availability of reliable and affordable blood pressure monitoring devices and access to information and resources on how to perform self-monitoring may impact patients' likelihood of engaging in this practice [ 21 ]. A number of studies suggest that provider-related factors affect SMBP and highlight the importance of a supportive health system for effective hypertension self-management, such as ease of access to healthcare facilities for follow-up and guidance, and healthcare providers’ support for patients [ 22 ]. While the benefits of SMBP are well-documented in international literature, there is limited understanding of its application and influencing factors among hypertensive patients within primary health care (PHC) settings in Vietnam. Acquiring more insights is relevant because the country foresees a crucial role of the PHC system in NCD management, with the provision of regular hypertension treatment under the social health insurance programme being a core strategy for NCD control [ 23 ]. Commune health stations (CHSs) serve as the first point of care for the people in each commune, offering insured patients’ free regular treatment for hypertension. In addition, with a modest co-payment, insured patients can seek outpatient treatment at district hospitals or higher-level public and private health facilities. Hypertensive patients are entitled to monthly consultations at these facilities, which include blood pressure monitoring, clinical assessments, counselling, and medication prescriptions. SMBP is supposed to be part of the treatment regimen. Despite this structured care system, there is a gap in knowledge about how frequently and effectively hypertensive patients engage in SMBP. This study aims to assess the personal and health system related factors influencing adoption of SMBP among patients with hypertension managed in the PHC facilities in urban and rural communes in two provinces in Vietnam. METHODS Study design and setting A cross-sectional survey was conducted among hypertensive patients managed by 21 purposely selected CHSs, each located in a different commune, across four districts in Ninh Binh province and three districts in Hai Phong city, Vietnam (three communes per district). Ninh Binh, a northern province in the Red River Delta, has a population of over 1.2 million, with 78.4% residing in rural areas. In this province, all selected CHSs provided outpatient services through the social health insurance programme. Hai Phong, a nearby city in the same region, has a population of approximately 2.1 million, with 54.3% living in peri-urban areas [ 24 ]. However, in Hai Phong, six CHSs in two peri-urban districts did offer outpatient services covered by social health insurance, while three CHSs in an urban district did not provide curative services. Consequently, insured patients in these areas had to seek care at higher-level public health facilities, or from private providers. Sampling and data collection In 2021, a sample of 989 patients with a confirmed diagnosis of hypertension was recruited from participating CHSs. The study team obtained lists of patients diagnosed with hypertension from each CHS. Next, aggregated lists were created for each district by combining patient lists from three local CHSs. From these district lists, patients were randomly chosen to participate in the survey. Eligible patients participated in face-to-face interviews at their local CHSs. Trained enumerators conducted these interviews utilising structured quantitative questionnaires developed with ODK software, installed on mobile tablets. Variables Dependent variables In this study, SMBP was ascertained by patient’s self-reported dichotomised questions with a yes or no response to “Do you currently self-monitor your blood pressure using a self-monitoring blood pressure device?”. The follow-up questions were asked to identify whether patients actually performed SMBP, including “How often do you measure your BP?” and “How do you measure your BP yourself?”. The SMBP status was confirmed following two criteria: (i) frequency of SMBP: daily or weekly; (ii) the place of SMBP should be a non-clinical setting, such as, at home, or at others’ people home, such as friends, relative. Independent variables The study's independent variables encompassed a comprehensive range of socio-economic, demographic, and health-related topics, along with an assessment of knowledge, attitudes, and practices (KAP) related to hypertension. Socio-economic and demographic variables included age group, gender, marital status, educational attainment; and occupation, and residential areas (urban or rural). The disease-related variables comprised a diverse set of topics, including comorbidities with NCDs, family history of hypertension, a diagnosis of hypertension-related complications, duration of hypertension, and self-assessment of hypertension control. For the self-assessment of hypertension control, patients were asked whether they perceived their blood pressure to be under control according to professional recommendations. Health service utilisation encompassed the type of treatment received and the healthcare facilities providing treatment for hypertension. In terms of health coverage, variables refer to health insurance enrolment and the specific type of health insurance held by participants. The questions related to participants' practices encompass their adherence to healthy lifestyles, including dietary habits and exercise routines, as well as the avoidance of risky behaviours such as smoking and alcohol consumption, along with medication adherence. Questions were drawn from the well-established WHO-STEPS survey questionnaires employed in the Vietnam National STEPs Survey [ 25 ]. Additionally, these questions were adapted to be consistent with the guidelines for regular management of hypertension at the primary health care level by the Vietnam Ministry of Health [ 26 ]. The knowledge questionnaire comprised 15 true-false questions covering specific knowledge topics. Each correct response was awarded 1 point, while incorrect responses received 0 points. The knowledge score was the sum of the 15 questions, ranging from 0 to 15 points. The attitude questionnaire for patients with hypertension included 13 items on a 5-point Likert scale. Respondents indicated their level of agreement or disagreement with each statement, reflecting their perspectives on hypertension and disease management. The attitude score was calculated as the average of the 13 responses, ranging from 1 to 5 points. The practice questions assessed key hypertension management behaviours that support blood pressure control, including non-smoking, regular exercise, adherence to a low-salt diet, management by a healthcare facility, and current use of antihypertensive medications. Data analysis Categorical variables were assessed for associations using the Chi-square test, while the ANOVA was employed for continuous variables demonstrating a normal distribution. Meanwhile, the Kruskal-Wallis test was applied for continuous variables displaying non-normal distributions, examining the association with the independent variables and outcomes. Given that the outcome variable was configured in binary form, a multivariate logistic regression analysis was executed to discern the factors contributing to SMBP. Categorical independent variables featuring more than two categories underwent conversion into multiple binary dummy variables, rendering them compatible with the regression models. The multivariate logistic analysis was carried out following backward elimination approach to refine the model. Additionally, potential effect modifications in the pertinent associations were subjected to testing. The fit of the final model was assessed through the application of the goodness of fit test and the assessment of the area under the Receiver Operating Characteristic (ROC) curve. The statistical analyses were performed using the STATA/IC Version 14 software package. RESULTS Patients’ characteristics As illustrated in Table 1, almost 85% of the patients with hypertension (PWH) were aged 60 years and above, with males comprising 43.9% of the total. Only a quarter of the respondents had completed high school or attained higher education. Approximately one-fifth of the patients were either unemployed or not working and one-third of them were retired while 45.8% were working. Almost all patients were insured (99.8%) and one-third of them were voluntarily enrolled. Insert Table 1: Patients’ characteristics by provinces Table 1: Patients’ characteristics by provinces Ninh Binh n=640 Hai Phong n=349 All n=989 n % n % n % Demographic and socioeconomic backgrounds Age groups - < 50 years - 50-59 years - 60-69 years - ≥ 70 years 20 93 303 224 3.1 14.5 47.3 35.0 10 33 151 155 2.9 9.5 43.3 44.4 30 126 454 379 3.0 12.7 45.9 38.3 Male patients 269 42.0 165 47.3 434 43.9 Marital status - Unmarried - Married - Divorced/widowed/ separated 13 504 123 2.0 78.8 19.2 4 271 74 1.1 77.7 21.2 17 775 197 1.7 78.4 19.9 Highest educational level - Lower than primary school - Primary school - Secondary school - High school - Graduate 69 80 355 88 48 10.8 12.5 55.5 13.7 7.5 30 46 169 62 42 8.6 13.2 48.4 17.8 12.0 99 126 524 150 90 10.0 12.7 53.0 15.2 9.1 Occupation - Employed/Currently working - Unemployed/not working - Pensioners 319 121 200 49.8 18.9 31.3 134 91 124 38.4 26.1 35.5 453 212 324 45.8 21.4 32.8 Living in rural areas 499 78.0 242 69.3 741 74.9 Health insurance coverage Patient with health insurance 639 99.8 348 99.7 987 99.8 Health insurance types - Fully subsidized HI - Partly subsidized HI - Voluntary HI - Private HI 349 47 221 22 54.6 7.4 34.6 3.4 216 43 80 9 62.1 12.4 23.0 2.6 565 90 301 31 57.2 9.1 30.5 3.1 With respect to the respondents' health status, 61,2% of the patients had been diagnosed with hypertension during the last five years, while only 14% were diagnosed over 10 years ago (Table 2). Furthermore, over half of the patients were suffering from at least one other chronic condition in addition to hypertension. It was found that 43.3% of them believed their blood pressure was adequately controlled. Additionally, 12.5% of patients had been diagnosed with a complication related to hypertension. Insert Table 2: Patients’ health status and hypertension management practice Table 2: Patients’ health status and hypertension management practice Ninh Binh n=640 Hai Phong n=349 All n=989 n % n % n % Number of comorbidities apart from hypertension - Only hypertension - 1 NCD - 2+ NCDs 304 194 142 47.5 30.3 22.2 127 126 96 36.4 36.1 27.5 431 320 238 43.6 32.4 24.1 Self-assessment of hypertension under control 291 45.5 138 39.5 429 43.3 Period since the first diagnosis of hypertension - 1 year - 2-5 years - 6-10 years - > 10 years 103 325 145 67 16.1 50.8 22.7 10.5 40 137 100 72 11.5 27.5 40.4 20.6 143 462 245 139 14.5 46.7 24.8 14.0 Patients with complications of hypertension 70 10.9 54 15.5 124 12.5 Facilities that patients with hypertension is currently treated - Self-medication/no treatment - Commune health stations - District health centers - Higher-level hospitals - Private health facilities 86 413 119 17 5 13.4 64.5 18.6 2.7 0.8 129 77 95 42 6 37.0 22.1 27.2 12.0 1.7 215 490 214 59 11 21.7 49.5 21.6 6.0 1.1 No smoking 583 91.1 305 87.4 888 89.8 PWH take less than 2+ drinks and 5 days a week 614 95.9 333 95.4 947 95.8 PWH is doing regular physical exercise 450 70.3 262 75.1 712 72.0 PWH has a low-salt intake diet 280 43. 7 167 47.8 447 45.2 PWH is currently taking anti-hypertensive medications 618 96.6 322 92.3 940 95.0 Approximately half (49.5%) of the patients were presently receiving treatment at their local CHS, while 28.7% were treated by higher-level facilities. 21.7%, were not under the management of any healthcare facility, and instead opted for self-medication or no treatment. Regarding the adoption of a healthy lifestyle, most patients reported adhering to recommended practices. Specifically, a significant percentage refrained from smoking (89.8%), engaged in regular exercise (72%), and practiced moderate alcohol consumption (95.8%). Furthermore, 95% of patients were currently taking anti-hypertensive medication. However, over half of the patients (54.8%) did not maintain a low-salt intake diet. Practice of self-monitoring blood pressure As shown in Table 3, it was reported that 43.1% of patients with hypertension self-monitored their blood pressure regularly. Of those who engaged in SMBP, 42.3% tracked their blood pressure daily while 57.7% measured blood pressure at least weekly. Regarding the circumstance of SMBP, 80.3% used home sphygmomanometers and 12% sought the support from their friends or relatives who had home-based sphygmomanometers. Table 3: SMBP among patient with hypertension Ninh Binh n=640 Hai Phong n=349 All n=989 n % n % n % Patients who are self-monitoring their blood pressure 295 46.1 131 37.5 426 43.1 Locations where patients self-monitored their blood pressure Patients’ home A friend/relative’s home A local health staff’s home A nearby health facility or pharmacy 234 41 10 9 79.6 13.9 3.4 3.1 107 10 1 13 81.7 7.6 0.8 9.9 341 51 11 22 80.2 12.0 2.6 5.2 Frequency of SMBP Daily Weekly 123 172 41.7 58.3 57 74 43.5 56.5 180 246 42.3 57.7 The factors influencing the adoption of SMBP As presented in Table 4, female patients, those living with a spouse or partner, individuals with higher levels of education, and those with income from employment or pensions were more likely to engage in self-monitoring of their blood pressure when compared to their counterparts with different sociodemographic profiles. Patients residing in Ninh Binh exhibited a notably higher prevalence of SMBP adoption compared to those living in Hai Phong. In addition, patients who reported higher levels of physical activity, adhered to a low-salt diet, and currently treated by a health facility seems to more be associated with SMBP practice. Patients who demonstrated better knowledge and a positive attitude towards managing their hypertension were more likely to engage in SMBP. Insert Table 4. The practice of SMBP by patient’s characteristics Table 4. The practice of SMBP by patient’s characteristics Self-monitoring P-values* No Yes n % n % Age groups ₋ < 60 years ₋ 60-69 years ₋ ≥ 70 years 81 270 212 51.9 59.5 55.9 75 184 167 48.1 40.5 44.1 0.230 Gender ₋ Male ₋ Female 336 227 60.5 52.3 219 207 39.5 47.7 0.009 Marital status ₋ Others ₋ Married 136 427 63.6 55.1 78 348 36.5 44.9 0.027 Highest educational level ₋ Primary school and lower ₋ Secondary school ₋ High school ₋ Graduate 154 289 78 42 68.4 55.1 52.0 46.7 71 235 72 48 31.6 44.9 48.0 53.3 <0.001 Occupation ₋ Currently working ₋ Pensioners ₋ Unemployed/not working 263 91 209 58.1 42.9 64.5 190 121 115 41.9 57.1 35.5 <0.001 Province of residence ₋ Hai Phong ₋ Ninh Binh 218 345 62.5 53.9 131 295 37.5 46.1 0.009 Rural/urban ₋ Urban ₋ Rural 131 432 52.8 58.3 117 309 47.2 41.7 0.132 Health insurance types ₋ Fully subsidized HI ₋ Partly subsidized HI ₋ Voluntary HI 315 57 190 55.8 63.3 57.2 250 33 142 44.2 36.7 42.8 0.399 Self-assessment of HTN under control ₋ No ₋ Yes 345 237 60.3 53.6 227 199 40.5 46.4 0.066 Time period since the first diagnosis ₋ 1 year ₋ 2-5 years ₋ 6-10 years - > 10 years 90 205 189 79 62.9 58.1 53.4 56.8 53 148 165 60 37.1 41.9 46.6 43.2 0.251 Any diagnosed complications of HTN ₋ No ₋ Yes 68 495 54.8 57.2 56 370 45.2 42.8 0.616 Number of comorbidities apart from HTN ₋ Only HTN ₋ 1 NCD ₋ 2+ NCDs 261 179 123 60.6 55.9 51.9 170 141 115 39.4 44.1 48.3 0.077 Smoking - No - Yes 501 62 56.4 61.4 387 39 43.6 38.6 0.339 Take less than two standard drinks five days a week - No - Yes 539 24 56.9 57.1 408 18 43.1 42.9 0.977 Regular physical exercise - No - Yes 182 381 65.7 53.5 95 331 34.3 46.5 0.001 Low-salt intake diet (less than 5 grams per day)? - No - Yes 329 234 60.7 52.4 213 213 39.3 47.7 0.008 Currently treated at a health facility - No - Yes 144 419 67.0 54.1 71 355 33.0 45.9 0.001 Facilities that PWH is currently treated - Self-medication/no treatment - Commune health station - District health centres - Higher-level hospitals 144 268 117 34 67.0 54.7 54.7 48.6 71 222 97 36 33.0 45.3 45.3 51.4 0.006 Mean total knowledge score (SD) 10.85 (3.55) 11.89 (2.60) <0.001 Mean attitude score (SD) 3.55 (0.61) 3.63 (0.58) 0.016 * Note: Categorical variables were applied the Chi-square test and Mann-Whitney test was applied for continuous variables displaying non-normal distributions The multivariable logistic regression analysis revealed that occupation, knowledge of hypertension management, regular physical activities, and province of residence were significant factors associated with SMBP practice among patients with hypertension (Table 5). Pensioners were 2.2 times (OR=2.2.; p<0.001) more likely to adopt SMBP compared to those who were unemployed or not working. Patients who demonstrated a better understanding of hypertension management had a higher odds ratio (OR=1.10; p<0.001) of engaging in SMBP practices. Engaging in regular physical activities was another significant factor associated with SMBP adoption. Patients who reported being physically active had 1.54 times higher odds (OR=1.54; p=0.005) of practicing SMBP. Finally, patients who resided in Ninh Binh were 1.58 times (OR=1.58; p=0.001) more likely to SMBP compared to those living in Hai Phong. Table 5. The multivariate logistic analysis determining individual factors associated with SMBP practice among hypertensive patients. Variables Adjusted-OR SE p-values 95% CI Occupation Unemployed/not working Employed/Currently working Pensioners 1 1.29 2.23 - 0.20 0.41 - 0.098 < 0.001 - 0.95 1.55 - 1.74 3.20 Knowledge about hypertension 1.10 0.03 < 0.001 1.05 1.15 Regular physical exercise No Yes 1 1.54 - 2.83 - 0.005 1.14 2.08 Province of residence Ninh Binh Hai Phong 1.58 1 3.24 - <0.001 1.20 2.09 DISCUSSION To the best of our knowledge, this study represents one of the pioneering efforts to evaluate both the extent and influencing factors on adoption of SMBP among individuals with hypertension in Vietnam. The findings emphasise that socioeconomic factors, specifically occupation status, patients' understanding of hypertension management, adherence to a healthy lifestyle, and residential location, are significant predictors for the practice of SMBP among hypertensive patients. These findings highlight the importance of targeted interventions to promote SMBP, considering sociodemographic and lifestyle factors to enhance hypertension management and control. The study revealed that 43.1% of patients with hypertension regularly self-monitored their blood pressure, with 42.3% doing so daily and 57.7% at least weekly. However, our figure is lower than a previous study conducted among similar populations by Hanh (2017) reporting that 53% of hypertensive patients engaged in home BP monitoring. Globally, engagement in SMBP among patients with hypertension ranged from 9–75% [ 27 – 33 ]. The prevalence of SMBP in our study was identical to the studies from Oman (40%) and Canada (45.9%) while it was lower than in some other countries [ 29 , 33 ]. For instance, in Italy, a multi-centre survey showed that 75% of hypertensive patients practice SMBP at home [ 27 ]. Another study in Pakistan reported notable SMBP engagement at 61.7% [ 28 ]. Conversely, our study surpassed others: in the United States, fewer than 25% of adults with hypertension participated in any home blood pressure monitoring [ 30 ]. Ethiopia had notably lower SMBP prevalence at 8.9%, while Singapore and UK reported 24% and 30%, respectively [ 31 , 32 ]. These international comparisons underscore the variability in SMBP practices among hypertensive populations. While our study provides valuable insights into the prevalence in Vietnam, the observed disparities highlight the influence of cultural, healthcare, and regional factors on self-monitoring behaviours. This discrepancy implies the necessity for context-specific healthcare interventions to enhance SMBP practices and hypertension management. Almost 85% of patients with hypertension enrolled in our study were older people. Evidently, older patients are more likely to suffer from NCDs, particularly hypertension, than their younger counterparts [ 34 ]. Previous studies indicated that older people prefer to seek care at the local health facilities, given their limited access to higher-level health facilities due to financial and transportation constraints [ 34 ]. As aforementioned, our study recruited patients who were managed by local CHSs and district hospitals and over 70% of them were currently treated by these PHC facilities. This can explain the dominant proportion of older people in our study sample. Therefore, the generalisability of the study results in the younger population with hypertension or those managed at higher-level health facilities may be limited. Future studies should consider including a more diverse age group and patients from various healthcare settings to ensure broader applicability of the findings. The findings from our study in Vietnam illuminate a compelling association between socioeconomic status, as inferred through occupational status, and the adoption of SMBP practices among patients with hypertension. In our sample, over 75% of patients had their personal income via their pension or employment. Notably, pensioners were 2.2 times more likely to embrace SMBP compared to unemployed individuals, underscoring the potential influence of retired individuals in prioritising their health and actively engaging in blood pressure monitoring. In parallel, currently employed individuals demonstrated a 1.3-fold higher likelihood of SMBP adoption, suggesting that those with active employment may also exhibit a better awareness of the importance of regular blood pressure monitoring. In the current study, over 80% of patients who engaged SMBP used their automated sphygmomanometers at home. Better-off patients were more likely to afford a home-based BP monitoring device than their socioeconomically disadvantaged counterparts. These findings align with studies highlighting the positive correlation between socioeconomic status, particularly employment, and health-seeking behaviours [ 35 – 38 ]. Comparisons with other studies in the literature may further elucidate these dynamics, providing a nuanced understanding of how socioeconomic disparities influence the adoption of SMBP across diverse populations and contexts. The multivariable regression analysis indicated that patients with a more profound understanding of hypertension management exhibited a significantly higher odds ratio of adopting SMBP, highlighting the pivotal role of knowledge in fostering proactive health behaviours. This finding is in line with a growing body of literature emphasising the importance of health literacy in NCD management, particularly self-management of hypertension, in Vietnam [ 39 , 40 ] and other LMICs [ 37 , 38 , 41 – 43 ]. In an integrative review, the authors concluded that better knowledge about hypertension self-management, such as BP control measures and modifiable risk factors, can play a central role in assisting patients in their self-care practice [ 37 ]. Studies across diverse settings consistently underscore the positive impact of health education and literacy programmes on empowering individuals to actively participate in the management of chronic conditions [ 22 , 44 – 48 ]. However, the nuanced contrasts across different contexts also unveil potential variations in the determinants of health literacy and its influence on health behaviours [ 46 , 48 ]. Recognising and addressing these contextual differences can inform tailored interventions aimed at improving health literacy and subsequently enhancing the adoption of SMBP practices among patients with hypertension in Vietnam and comparable LMICs. Future research might delve deeper into the specific components of health education that resonate most effectively with diverse populations, ensuring the development of targeted and culturally sensitive interventions. The current study identified a positive association between an active lifestyle and proactive disease management practice. Patients who reported engaging in regular physical activities exhibited a significant 1.5 times higher odds of practicing SMBP. This finding supports the existing literature emphasising the prioritization of increased physical activity as a key intervention strategy for self-managing hypertension in Vietnam [ 44 , 49 , 50 ], and LMICs [ 46 , 51 – 55 ]. It suggests the need for public health campaigns advocating for increased physical activity and highlights the direct link between an active lifestyle and self-monitoring practices. This study reveals a compelling association between residential location and the engagement of SMBP practice among patients with hypertension. Specifically, patients residing in Ninh Binh exhibited a significant 1.6 times higher chance of practicing SMBP compared to their counterparts in Hai Phong. In Ninh Binh, a majority of CHSs offered curative services under the social health insurance scheme, leading to 64.5% of patients seeking hypertension treatment at the lowest level of PHC (as shown in Table 2 ). Conversely, health insurance-based services were not widely available at the CHSs in urban settings of Hai Phong city. Consequently, the majority of patients resorted to self-medication (37.0%), sought treatment for hypertension at district hospitals or district health centres (27.2%), or higher-level hospitals (12.0%). Previous studies in Vietnam highlighted issues of patient overcrowding in public hospitals, resulting in minimal consultation time and compromised patient counselling quality [ 56 , 57 ]. The level of health facility for hypertension treatment can be a factor that influence SMBP. Further analysis with the current survey data shows that the proportion of patients received counselling services (55.6%) at the CHSs were higher than those at the district hospitals (46.2%) during the last periodical medical appointment (as reported in Appendix 4). This finding is consistent with results of a health facility survey among PHC facilities in Vietnam [ 58 ]. It was revealed that doctors at district hospitals spent less time per consultation and asked fewer questions per patient compared to doctors at CHSs [ 58 ]. One of possible explanation was that doctors in district hospitals exert lower effort on individual patients because they face heavier caseloads and thus having less time available per patient [ 58 ]. Integrated evidence from a systematic review suggests that SMBP, when integrated into patient-healthcare professionals' interactions or as part of a complex intervention to promote self-management of hypertension, is more likely to be effective than a single SMBP intervention [ 46 ]. Our study’s finding may illustrate how the availability of health insurance-based services at the CHSs in Ninh Binh may contribute to the increased likelihood of SMBP practice among patients with hypertension. This regional disparity may suggest the importance of considering variations in local healthcare settings when designing targeted interventions to promote disease self-management practices among patients with chronic NCDs in Vietnam. Several limitations were acknowledged in the study. The most important is that the outcome measures were self-reported. The use of self-reports for SMBP practice is common, and, in this study, respondents were carefully assessed with a set of questions. Similar methods have been used in other studies [ 36 , 38 ]. Furthermore, it is crucial to recognise that the predominant representation of older patients in the study sample may impose constraints on the generalisability of the findings to the broader population with hypertension in Vietnam. Although hypertension is commonly associated with older age, the skewed age distribution should be considered when interpreting the study's applicability to a more age-diverse population. CONCLUSION Our study provides important insights into the adoption and contributing factors of SMBP practices among hypertensive patients in Vietnam, an LMIC context where hypertension self-management remains suboptimal. With less than half of patients engaging in SMBP, there is a clear need to scale up this practice to improve hypertension control. Our findings underscore the role of knowledge, socioeconomic status, and healthcare service availability in facilitating SMBP, suggesting that interventions should prioritize vulnerable populations with limited resources. Efforts should focus on making SMBP devices more affordable through subsidies or market-based strategies, improving accessibility through community health programs, and strengthening the capacity of primary healthcare providers to educate and support patients in self-monitoring. A comprehensive, patient-centred approach that addresses financial and knowledge barriers can enhance SMBP adoption, ultimately improving hypertension management and reducing the burden of cardiovascular diseases in Vietnam. Declarations Ethical clearance Ethical approval for the implementation of the study was granted by the Health Research Ethics Committee of the Hanoi School of Public Health on 13th November 2019, the number 019-485/DD-YTCC. All participants received an explanation of the objectives of the research and the interview process. Written informed consent was obtained from each respondent before the survey. Consent for publication All contributing Authors give their consent for publication. Data and materials Additional data are available in additional files and the raw data on which this publication is based, are available from the corresponding author on request Competing interests The authors declare having no competing interests. Funding The SUNI-SEA research project was funded by the European Union’s Horizon 2020 research and innovation programme, call SC1-BHC-16-2018 Global Alliance for Chronic Diseases (GACD) - Scaling-up of evidence-based health interventions at population level for the prevention and management of hypertension and/or diabetes, soliciting for research in Low- and Middle-Income Countries (LMIC), under grant agreement No:825026. The funding source was not involved in the data collection, data analysis, manuscript writing and publication. Authors contributions Conceptualisation: NHG, NTPL, JK Data collection: NHG, NTPL, LTKA, TNT Data analysis: NHG, NTPL, DP, VR, JK Article production and review: NHG, NTPL, LTKA, DP, VR, TNT, JK Acknowledgement The authors thank all health professionals in the selected health facilities in Vietnam, who contributed voluntarily to this research for their time and devotion. Funding/Acknowledgements/Conflicts of interest This work has been supported by the European Union under the research and innovation programme [grant agreement No:825026], call SC1-BHC-16-2018 Global Alliance for Chronic Diseases (GACD) - Scaling-up of evidence-based health interventions at population level for the prevention and management of hypertension and/or diabetes, soliciting for research in Low- and Middle-Income Countries (LMIC). The funding source was not involved in the data collection, data analysis, manuscript writing and publication. All authors made a critical contribution to the process of conceptualisation, data collection, analysis and writing up of the results. The authors declare no conflict of interest References World Health Organization, Guideline for the pharmacological treatment of hypertension in adults . 2021, Geneva: World Health Organization. Institute for Health Metrics and Evaluation. High systolic blood pressure—Level 2 risk . 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Ostchega, Y., et al., Factors Associated With Home Blood Pressure Monitoring Among US Adults: National Health and Nutrition Examination Survey, 2011-2014. Am J Hypertens, 2017. 30 (11): p. 1126-1132. Tan, N.C., L.W. Khin, and R. Pagi, Home blood-pressure monitoring among hypertensive patients in an Asian population. Journal of Human Hypertension, 2005. 19 (7): p. 559-564. Baral-Grant, S., et al., Self-Monitoring of Blood Pressure in Hypertension: A UK Primary Care Survey. Int J Hypertens, 2012. 2012 : p. 582068. Dunia Al Hadithi, A.S.N. and S.A. Khan, Self Monitoring of Blood Pressure (SMBP) among Hypertensive patients in Muscat- A pilot study. Journal of Applied Pharmaceutical Science, 2012. 2 (9): p. 155-157. Vu, N.C., et al., Ageing and health in Viet Nam . 2020, Jakarta: ERIA and Ha Noi: PHAD: Hanoi, Vietnam. Wake, A.D., et al., The effect of the sociodemographic determinants of self-monitoring of blood pressure. 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Pham, V., et al., Factors Related to Self-Management Behaviours in Hypertensive Older Adults in Haiduong Province, Vietnam. Journal of Nursing and Health Sciences, 2016. 10 (3). Maginga, J., et al., Hypertension control and its correlates among adults attending a hypertension clinic in Tanzania. The Journal Of Clinical Hypertension, 2016. 18 (3): p. 207-216. Niriayo, Y.L., et al., Practice and predictors of self-care behaviors among ambulatory patients with hypertension in Ethiopia. PLoS One, 2019. 14 (6): p. e0218947. Irwan, A.M., et al., Self-Care Management for Hypertension in Southeast Asia: A Scoping Review. Journal of Multidisciplinary Healthcare, 2022. 15 (null): p. 2015-2032. Ha, D.A., et al., Conquering hypertension in Vietnam-solutions at grassroots level: study protocol of a cluster randomized controlled trial. Trials, 2020. 21 (1): p. 985. Khuong, Q.L., et al., Effect of community-based intervention on self-management of blood pressure among hypertensive adults: findings from the Communities for Healthy Hearts Quasi-experimental Study in Vietnam. J Glob Health Sci, 2020. 2 (1). Shahaj, O., et al., Supporting self-management for people with hypertension: a meta-review of quantitative and qualitative systematic reviews. J Hypertens, 2019. 37 (2): p. 264-279. Jafar, T.H., et al., Multicomponent intervention versus usual care for management of hypertension in rural Bangladesh, Pakistan and Sri Lanka: study protocol for a cluster randomized controlled trial. Trials, 2017. 18 (1): p. 272-272. Pardoel, Z.E., et al., Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia – a realist synthesis regarding hypertension and diabetes. BMC Public Health, 2021. 21 (1): p. 1917. Minh, B.C.A., et al., Đánh giá thay đổi tuân thủ một số biện phám kiểm huyết áp không dùng thuốc của người bệnh tăng huyết áp điều trị ngoại trú tại bệnh viện đa khoa tỉnh Nam Định. Khoa học Điều dưỡng, 2020. 3 (2): p. 86-93. Hoa, L.T., et al., Nâng cao hành vi tăng cường sức khỏe của người bệnh tăng huyết điều trị ngoại trú tại phương Đồng Quang, thành phố Thái Nguyên. Tạp chí Khoa học và Công nghệ, 2018. 177 (01): p. 135-140. Glynn, L.G., et al., Interventions used to improve control of blood pressure in patients with hypertension. Cochrane database of systematic reviews, 2010. 17 (3). Treciokiene, I., et al., Healthcare professional-led interventions on lifestyle modifications for hypertensive patients–a systematic review and meta-analysis. BMC family practice, 2021. 22 (1): p. 1-15. Xiao, J., et al., Effectiveness of Lifestyle and Drug Intervention on Hypertensive Patients: a Randomized Community Intervention Trial in Rural China. Journal of General Internal Medicine, 2020. 35 (12): p. 3449-3457. Sutipan, P., et al., Effects of self-management program on healthy lifestyle behaviors among elderly with hypertension. International Journal of Behavioral Science, 2018. 13 (2): p. 38-50. Putri, S.E., E. Rekawati, and D.N.K. Wati, Effectiveness of Self-Management on Adherence to Self-Care and on Health Status among Elderly People with Hypertension. Journal of Public Health Research, 2021. 10 . Nguyen, M.P., et al., Why do consumers choose private over public health services? Reflective accounts of health providers in Vietnam. BMC Health Services Research, 2023. 23 (1): p. 900. Tran, T.Q., et al., Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context. BMC Health Services Research, 2020. 20 (1): p. 946. The World Bank, Quality and Equity in Basic Health Care Services in Vietnam: Findings from the 2015 Vietnam District and Commune Health Facility Survey . 2016, The World Bank: Washington. Additional Declarations No competing interests reported. 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Hypertension is annually accounting for 235\u0026nbsp;million disability adjusted life years lost (DALY) and 10.8\u0026nbsp;million deaths [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The prevalence of hypertension has increased dramatically in recent decades [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. About 78% of adults with hypertension is living in low- and middle-income countries [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Despite effective prevention and treatment options, hypertension remains underdiagnosed, undertreated, and under-controlled in many countries [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Globally, among adults aged 30\u0026ndash;79 years with hypertension, only 54% has been diagnosed, 42% is receiving treatment, and 21% has the hypertension under control [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Evidence shows that a low treatment adherence among patients with hypertension is significantly associated with several adverse cardiovascular outcomes [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Vietnam, non-communicable diseases (NCDs) have become the main cause of morbidity and mortality, with cardiovascular diseases being the primary contributor responsible for 42% of deaths and contributing 17% of the total DALYs related to NCDs [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Hypertension, one of the most common chronic NCDs, affects over 26.2% of the adult population in the country. However, only 24.7% of people with hypertension were being managed at health facilities, and just one third of hypertensive patients on anti-hypertensive medication had their blood pressure under control in 2021 [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe best way to prevent stroke and heart disease is by managing high blood pressure effectively [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Self-monitoring and self-management of blood pressure can be successful in lowering blood pressure levels in patients with hypertension [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Extensive evidence suggests that self-monitoring of blood pressure (SMBP) is associated with a reduction of systolic blood pressure among patients with hypertension compared to periodical measurement in medical settings [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. As SMBP offers advantages over clinic measurements, several international hypertension guidelines endorse SMBP [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. It allows for multiple readings over time and in the patient's usual environment, producing a more reliable blood pressure value that is not influenced by the \u0026ldquo;white coat\u0026rdquo; or placebo effects [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Extensive evidence indicates that SMBP is associated with significant reduction in blood pressure and improved hypertension control, with the greatest benefits observed when combined with other interventions[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Incorporating SMBP alongside clinical-setting BP measurement has been shown to be cost-effective compared to clinical BP monitoring alone or standard care for individuals with hypertension. SMBP fosters patients\u0026rsquo; involvement in their care and promotes treatment adherence [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. According to a systematic review with meta-analysis, SMBP has been found to have positive effects on patients with hypertension-related comorbidities as well as those with specific conditions such as obesity [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrevious studies have found several factors influencing adoption of SMBP among patients with hypertension. These include age, gender, education level, income, perceived health status, presence of comorbidities, use of antihypertensive medication, access to healthcare, and social support [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Other factors such as patients' beliefs about the importance of self-monitoring and their confidence in their ability to perform the task may also play a role [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, factors such as the availability of reliable and affordable blood pressure monitoring devices and access to information and resources on how to perform self-monitoring may impact patients' likelihood of engaging in this practice [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. A number of studies suggest that provider-related factors affect SMBP and highlight the importance of a supportive health system for effective hypertension self-management, such as ease of access to healthcare facilities for follow-up and guidance, and healthcare providers\u0026rsquo; support for patients [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile the benefits of SMBP are well-documented in international literature, there is limited understanding of its application and influencing factors among hypertensive patients within primary health care (PHC) settings in Vietnam. Acquiring more insights is relevant because the country foresees a crucial role of the PHC system in NCD management, with the provision of regular hypertension treatment under the social health insurance programme being a core strategy for NCD control [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Commune health stations (CHSs) serve as the first point of care for the people in each commune, offering insured patients\u0026rsquo; free regular treatment for hypertension. In addition, with a modest co-payment, insured patients can seek outpatient treatment at district hospitals or higher-level public and private health facilities. Hypertensive patients are entitled to monthly consultations at these facilities, which include blood pressure monitoring, clinical assessments, counselling, and medication prescriptions. SMBP is supposed to be part of the treatment regimen. Despite this structured care system, there is a gap in knowledge about how frequently and effectively hypertensive patients engage in SMBP. This study aims to assess the personal and health system related factors influencing adoption of SMBP among patients with hypertension managed in the PHC facilities in urban and rural communes in two provinces in Vietnam.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eA cross-sectional survey was conducted among hypertensive patients managed by 21 purposely selected CHSs, each located in a different commune, across four districts in Ninh Binh province and three districts in Hai Phong city, Vietnam (three communes per district). Ninh Binh, a northern province in the Red River Delta, has a population of over 1.2\u0026nbsp;million, with 78.4% residing in rural areas. In this province, all selected CHSs provided outpatient services through the social health insurance programme.\u003c/p\u003e \u003cp\u003eHai Phong, a nearby city in the same region, has a population of approximately 2.1\u0026nbsp;million, with 54.3% living in peri-urban areas [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. However, in Hai Phong, six CHSs in two peri-urban districts did offer outpatient services covered by social health insurance, while three CHSs in an urban district did not provide curative services. Consequently, insured patients in these areas had to seek care at higher-level public health facilities, or from private providers.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSampling and data collection\u003c/h3\u003e\n\u003cp\u003eIn 2021, a sample of 989 patients with a confirmed diagnosis of hypertension was recruited from participating CHSs. The study team obtained lists of patients diagnosed with hypertension from each CHS. Next, aggregated lists were created for each district by combining patient lists from three local CHSs. From these district lists, patients were randomly chosen to participate in the survey. Eligible patients participated in face-to-face interviews at their local CHSs. Trained enumerators conducted these interviews utilising structured quantitative questionnaires developed with ODK software, installed on mobile tablets.\u003c/p\u003e\n\u003ch3\u003eVariables\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDependent variables\u003c/h2\u003e \u003cp\u003eIn this study, SMBP was ascertained by patient\u0026rsquo;s self-reported dichotomised questions with a yes or no response to \u0026ldquo;Do you currently self-monitor your blood pressure using a self-monitoring blood pressure device?\u0026rdquo;. The follow-up questions were asked to identify whether patients actually performed SMBP, including \u0026ldquo;How often do you measure your BP?\u0026rdquo; and \u0026ldquo;How do you measure your BP yourself?\u0026rdquo;. The SMBP status was confirmed following two criteria: (i) frequency of SMBP: daily or weekly; (ii) the place of SMBP should be a non-clinical setting, such as, at home, or at others\u0026rsquo; people home, such as friends, relative.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eIndependent variables\u003c/h3\u003e\n\u003cp\u003eThe study's independent variables encompassed a comprehensive range of socio-economic, demographic, and health-related topics, along with an assessment of knowledge, attitudes, and practices (KAP) related to hypertension. Socio-economic and demographic variables included age group, gender, marital status, educational attainment; and occupation, and residential areas (urban or rural). The disease-related variables comprised a diverse set of topics, including comorbidities with NCDs, family history of hypertension, a diagnosis of hypertension-related complications, duration of hypertension, and self-assessment of hypertension control. For the self-assessment of hypertension control, patients were asked whether they perceived their blood pressure to be under control according to professional recommendations. Health service utilisation encompassed the type of treatment received and the healthcare facilities providing treatment for hypertension.\u003c/p\u003e \u003cp\u003eIn terms of health coverage, variables refer to health insurance enrolment and the specific type of health insurance held by participants. The questions related to participants' practices encompass their adherence to healthy lifestyles, including dietary habits and exercise routines, as well as the avoidance of risky behaviours such as smoking and alcohol consumption, along with medication adherence. Questions were drawn from the well-established WHO-STEPS survey questionnaires employed in the Vietnam National STEPs Survey [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Additionally, these questions were adapted to be consistent with the guidelines for regular management of hypertension at the primary health care level by the Vietnam Ministry of Health [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The knowledge questionnaire comprised 15 true-false questions covering specific knowledge topics. Each correct response was awarded 1 point, while incorrect responses received 0 points. The knowledge score was the sum of the 15 questions, ranging from 0 to 15 points. The attitude questionnaire for patients with hypertension included 13 items on a 5-point Likert scale. Respondents indicated their level of agreement or disagreement with each statement, reflecting their perspectives on hypertension and disease management. The attitude score was calculated as the average of the 13 responses, ranging from 1 to 5 points. The practice questions assessed key hypertension management behaviours that support blood pressure control, including non-smoking, regular exercise, adherence to a low-salt diet, management by a healthcare facility, and current use of antihypertensive medications.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eCategorical variables were assessed for associations using the Chi-square test, while the ANOVA was employed for continuous variables demonstrating a normal distribution. Meanwhile, the Kruskal-Wallis test was applied for continuous variables displaying non-normal distributions, examining the association with the independent variables and outcomes.\u003c/p\u003e \u003cp\u003eGiven that the outcome variable was configured in binary form, a multivariate logistic regression analysis was executed to discern the factors contributing to SMBP. Categorical independent variables featuring more than two categories underwent conversion into multiple binary dummy variables, rendering them compatible with the regression models. The multivariate logistic analysis was carried out following backward elimination approach to refine the model. Additionally, potential effect modifications in the pertinent associations were subjected to testing. The fit of the final model was assessed through the application of the goodness of fit test and the assessment of the area under the Receiver Operating Characteristic (ROC) curve. The statistical analyses were performed using the STATA/IC Version 14 software package.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003ePatients\u0026rsquo; characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs illustrated in Table 1, almost 85% of the patients with hypertension (PWH) were aged 60 years and above, with males comprising 43.9% of the total. Only a quarter of the respondents had completed high school or attained higher education. Approximately one-fifth of the patients were either unemployed or not working and one-third of them were retired while 45.8% were working. Almost all patients were insured (99.8%) and one-third of them were voluntarily enrolled. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert Table 1: Patients\u0026rsquo; characteristics by provinces\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1: Patients\u0026rsquo; characteristics by provinces\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNinh Binh\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=640\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHai Phong\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=349\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=989\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemographic and socioeconomic backgrounds\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eAge groups\u003c/p\u003e\n \u003cp\u003e- \u0026lt; 50 years\u003c/p\u003e\n \u003cp\u003e- 50-59 years\u003c/p\u003e\n \u003cp\u003e- 60-69 years\u003c/p\u003e\n \u003cp\u003e- \u0026ge; 70 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003cp\u003e303\u003c/p\u003e\n \u003cp\u003e224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003cp\u003e47.3\u003c/p\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003cp\u003e43.3\u003c/p\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003cp\u003e454\u003c/p\u003e\n \u003cp\u003e379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003cp\u003e38.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eMale patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e42.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e47.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e434\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e43.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003cp\u003e- Unmarried\u003c/p\u003e\n \u003cp\u003e- Married\u003c/p\u003e\n \u003cp\u003e- Divorced/widowed/\u003c/p\u003e\n \u003cp\u003eseparated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e504\u003c/p\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003cp\u003e78.8\u003c/p\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003cp\u003e77.7\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e775\u003c/p\u003e\n \u003cp\u003e197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003cp\u003e78.4\u003c/p\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eHighest educational level\u003c/p\u003e\n \u003cp\u003e- Lower than primary school\u003c/p\u003e\n \u003cp\u003e- Primary school\u003c/p\u003e\n \u003cp\u003e- Secondary school\u003c/p\u003e\n \u003cp\u003e- High school\u003c/p\u003e\n \u003cp\u003e- Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003cp\u003e355\u003c/p\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003cp\u003e55.5\u003c/p\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003cp\u003e48.4\u003c/p\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003cp\u003e524\u003c/p\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003cp\u003e53.0\u003c/p\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003cp\u003e- Employed/Currently working\u003c/p\u003e\n \u003cp\u003e- Unemployed/not working\u003c/p\u003e\n \u003cp\u003e- Pensioners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49.8\u003c/p\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003cp\u003e31.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e38.4\u003c/p\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e453\u003c/p\u003e\n \u003cp\u003e212\u003c/p\u003e\n \u003cp\u003e324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45.8\u003c/p\u003e\n \u003cp\u003e21.4\u003c/p\u003e\n \u003cp\u003e32.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eLiving in rural areas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e69.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e74.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth insurance coverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003ePatient with health insurance\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e639\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e99.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e348\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e99.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e99.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eHealth insurance types\u003c/p\u003e\n \u003cp\u003e- Fully subsidized HI\u003c/p\u003e\n \u003cp\u003e- Partly subsidized HI\u003c/p\u003e\n \u003cp\u003e- Voluntary HI\u003c/p\u003e\n \u003cp\u003e- Private HI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e349\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e54.6\u003c/p\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003cp\u003e34.6\u003c/p\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62.1\u003c/p\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003cp\u003e23.0\u003c/p\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e565\u003c/p\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e57.2\u003c/p\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWith respect to the respondents\u0026apos; health status, 61,2% of the patients had been diagnosed with hypertension during the last five years, while only 14% were diagnosed over 10 years ago (Table 2). Furthermore, over half of the patients were suffering from at least one other chronic condition in addition to hypertension. It was found that 43.3% of them believed their blood pressure was adequately controlled. Additionally, 12.5% of patients had been diagnosed with a complication related to hypertension.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert\u0026nbsp;Table 2: Patients\u0026rsquo; health status and hypertension management practice\u003c/p\u003e\n\u003cp\u003eTable 2: Patients\u0026rsquo; health status and hypertension management practice\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"647\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNinh Binh\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=640\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHai Phong\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=349\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=989\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003eNumber of comorbidities apart from hypertension\u003c/p\u003e\n \u003cp\u003e- Only hypertension\u003c/p\u003e\n \u003cp\u003e- 1 NCD\u003c/p\u003e\n \u003cp\u003e- 2+ NCDs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e304\u003c/p\u003e\n \u003cp\u003e194\u003c/p\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003cp\u003e30.3\u003c/p\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e127\u003c/p\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e36.4\u003c/p\u003e\n \u003cp\u003e36.1\u003c/p\u003e\n \u003cp\u003e27.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e431\u003c/p\u003e\n \u003cp\u003e320\u003c/p\u003e\n \u003cp\u003e238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003eSelf-assessment of hypertension under control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e39.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e43.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePeriod since the first diagnosis of hypertension\u003c/p\u003e\n \u003cp\u003e- 1 year\u003c/p\u003e\n \u003cp\u003e- 2-5 years\u003c/p\u003e\n \u003cp\u003e- 6-10 years\u003c/p\u003e\n \u003cp\u003e- \u0026gt; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003cp\u003e325\u003c/p\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003cp\u003e50.8\u003c/p\u003e\n \u003cp\u003e22.7\u003c/p\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003cp\u003e27.5\u003c/p\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003cp\u003e462\u003c/p\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003cp\u003e24.8\u003c/p\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePatients with complications of hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003eFacilities that patients with hypertension is currently treated\u003c/p\u003e\n \u003cp\u003e- Self-medication/no treatment\u003c/p\u003e\n \u003cp\u003e- Commune health stations\u003c/p\u003e\n \u003cp\u003e- District health centers\u003c/p\u003e\n \u003cp\u003e- Higher-level hospitals\u003c/p\u003e\n \u003cp\u003e- Private health facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003cp\u003e413\u003c/p\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13.4\u003c/p\u003e\n \u003cp\u003e64.5\u003c/p\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37.0\u003c/p\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003cp\u003e27.2\u003c/p\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e215\u003c/p\u003e\n \u003cp\u003e490\u003c/p\u003e\n \u003cp\u003e214\u003c/p\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003eNo smoking\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e87.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePWH take less than 2+ drinks and 5 days a week\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e95.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e95.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e95.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePWH is doing regular physical exercise\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e70.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e75.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e712\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e72.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePWH has a low-salt intake diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e43. 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e47.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e447\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003ePWH is currently taking anti-hypertensive medications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e96.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e92.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e95.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eApproximately half (49.5%) of the patients were presently receiving treatment at their local CHS, while 28.7% were treated by higher-level facilities. 21.7%, were not under the management of any healthcare facility, and instead opted for self-medication or no treatment.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding the adoption of a healthy lifestyle, most patients reported adhering to recommended practices. Specifically, a significant percentage refrained from smoking (89.8%), engaged in regular exercise (72%), and practiced moderate alcohol consumption (95.8%). Furthermore, 95% of patients were currently taking anti-hypertensive medication. However, over half of the patients (54.8%) did not maintain a low-salt intake diet.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePractice of self-monitoring blood pressure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs shown in Table 3, it was reported that 43.1% of patients with hypertension self-monitored their blood pressure regularly. Of those who engaged in SMBP, 42.3% tracked their blood pressure daily while 57.7% measured blood pressure at least weekly. Regarding the circumstance of SMBP, 80.3% used home\u0026nbsp;sphygmomanometers and 12% sought the support from their friends or relatives who had home-based sphygmomanometers.\u003c/p\u003e\n\u003cp\u003eTable 3: SMBP among patient with hypertension\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"120%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNinh Binh\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=640\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHai Phong\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=349\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=989\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatients who are self-monitoring their blood pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e46.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocations where patients self-monitored their blood pressure\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePatients\u0026rsquo; home\u003c/p\u003e\n \u003cp\u003eA friend/relative\u0026rsquo;s home\u003c/p\u003e\n \u003cp\u003eA local health staff\u0026rsquo;s home\u003c/p\u003e\n \u003cp\u003eA nearby health facility or pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e234\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e79.6\u003c/p\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.7\u003c/p\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e341\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e80.2\u003c/p\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of SMBP\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eDaily\u003c/p\u003e\n \u003cp\u003eWeekly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e180\u003c/p\u003e\n \u003cp\u003e246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e42.3\u003c/p\u003e\n \u003cp\u003e57.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eThe factors influencing the adoption of SMBP\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs presented in Table 4, female patients, those living with a spouse or partner, individuals with higher levels of education, and those with income from employment or pensions were more likely to engage in self-monitoring of their blood pressure when compared to their counterparts with different sociodemographic profiles. Patients residing in Ninh Binh exhibited a notably higher prevalence of SMBP adoption compared to those living in Hai Phong. In addition, patients who reported higher levels of physical activity, adhered to a low-salt diet, and currently treated by a health facility seems to more be associated with SMBP practice. Patients who demonstrated better knowledge and a positive attitude towards managing their hypertension were more likely to engage in SMBP.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert\u0026nbsp;Table 4. The practice of SMBP by patient\u0026rsquo;s characteristics\u003c/p\u003e\n\u003cp\u003eTable 4. The practice of SMBP by patient\u0026rsquo;s characteristics\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"567\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-monitoring\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-values*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge groups\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;\u0026lt; 60 years\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;60-69 years\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;\u0026ge; 70 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003cp\u003e270\u003c/p\u003e\n \u003cp\u003e212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e51.9\u003c/p\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48.1\u003c/p\u003e\n \u003cp\u003e40.5\u003c/p\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e336\u003c/p\u003e\n \u003cp\u003e227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60.5\u003c/p\u003e\n \u003cp\u003e52.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e39.5\u003c/p\u003e\n \u003cp\u003e47.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Others\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003cp\u003e427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e63.6\u003c/p\u003e\n \u003cp\u003e55.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003cp\u003e348\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e36.5\u003c/p\u003e\n \u003cp\u003e44.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.027\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest educational level\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Primary school and lower\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Secondary school\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;High school\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e154\u003c/p\u003e\n \u003cp\u003e289\u003c/p\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e68.4\u003c/p\u003e\n \u003cp\u003e55.1\u003c/p\u003e\n \u003cp\u003e52.0\u003c/p\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e235\u003c/p\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003cp\u003e44.9\u003c/p\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003cp\u003e53.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Currently working\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Pensioners\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Unemployed/not working\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e263\u003c/p\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e58.1\u003c/p\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003cp\u003e64.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProvince of residence\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Hai Phong\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Ninh Binh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003cp\u003e345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003cp\u003e53.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003cp\u003e46.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRural/urban\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Urban\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003cp\u003e309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e47.2\u003c/p\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth insurance types\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Fully subsidized HI\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Partly subsidized HI\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Voluntary HI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55.8\u003c/p\u003e\n \u003cp\u003e63.3\u003c/p\u003e\n \u003cp\u003e57.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e44.2\u003c/p\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003cp\u003e42.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.399\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eSelf-assessment of HTN under control\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e345\u003c/p\u003e\n \u003cp\u003e237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003cp\u003e53.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e227\u003c/p\u003e\n \u003cp\u003e199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e40.5\u003c/p\u003e\n \u003cp\u003e46.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eTime period since the first diagnosis\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;1 year\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;2-5 years\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;6-10 years\u003c/p\u003e\n \u003cp\u003e- \u0026gt; 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003cp\u003e189\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62.9\u003c/p\u003e\n \u003cp\u003e58.1\u003c/p\u003e\n \u003cp\u003e53.4\u003c/p\u003e\n \u003cp\u003e56.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37.1\u003c/p\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAny diagnosed complications of HTN\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003cp\u003e495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e54.8\u003c/p\u003e\n \u003cp\u003e57.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003cp\u003e370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003cp\u003e42.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eNumber of comorbidities apart from HTN\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;Only HTN\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;1 NCD\u003c/p\u003e\n \u003cp\u003e₋\u0026nbsp;\u0026nbsp;2+ NCDs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e261\u003c/p\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60.6\u003c/p\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003cp\u003e51.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e170\u003c/p\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e39.4\u003c/p\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003cp\u003e48.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eSmoking\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e501\u003c/p\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56.4\u003c/p\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e387\u003c/p\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eTake less than two standard drinks five days a week\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e539\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56.9\u003c/p\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e408\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eRegular physical exercise\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003cp\u003e381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e65.7\u003c/p\u003e\n \u003cp\u003e53.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003cp\u003e331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e34.3\u003c/p\u003e\n \u003cp\u003e46.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eLow-salt intake diet (less than 5 grams per day)?\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp; \u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e329\u003c/p\u003e\n \u003cp\u003e234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60.7\u003c/p\u003e\n \u003cp\u003e52.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e39.3\u003c/p\u003e\n \u003cp\u003e47.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCurrently treated at a health facility\u003c/p\u003e\n \u003cp\u003e- No\u003c/p\u003e\n \u003cp\u003e- Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003cp\u003e419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67.0\u003c/p\u003e\n \u003cp\u003e54.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eFacilities that PWH is currently treated\u003c/p\u003e\n \u003cp\u003e- Self-medication/no treatment\u003c/p\u003e\n \u003cp\u003e- Commune health station\u003c/p\u003e\n \u003cp\u003e- District health centres\u003c/p\u003e\n \u003cp\u003e- Higher-level hospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003cp\u003e268\u003c/p\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67.0\u003c/p\u003e\n \u003cp\u003e54.7\u003c/p\u003e\n \u003cp\u003e54.7\u003c/p\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e222\u003c/p\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003cp\u003e45.3\u003c/p\u003e\n \u003cp\u003e45.3\u003c/p\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMean total knowledge score (SD)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.85 (3.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11.89 (2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMean attitude score (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.55 (0.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.63 (0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 567px;\"\u003e\n \u003cp\u003e* \u003cem\u003eNote: Categorical variables were applied the Chi-square test and Mann-Whitney test was applied for continuous variables displaying non-normal distributions\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe multivariable logistic regression analysis revealed that occupation, knowledge of hypertension management, regular physical activities, and province of residence were significant factors associated with SMBP practice among patients with hypertension (Table 5). Pensioners were 2.2 times (OR=2.2.; p\u0026lt;0.001) more likely to adopt SMBP compared to those who were unemployed or not working. Patients who demonstrated a better understanding of hypertension management had a higher odds ratio (OR=1.10; p\u0026lt;0.001) of engaging in SMBP practices. Engaging in regular physical activities was another significant factor associated with SMBP adoption. Patients who reported being physically active had 1.54 times higher odds (OR=1.54; p=0.005) of practicing SMBP. Finally, patients who resided in Ninh Binh were 1.58 times (OR=1.58; p=0.001) more likely to SMBP compared to those living in Hai Phong. \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5. The multivariate logistic analysis determining individual factors associated with SMBP practice among hypertensive patients.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"648\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted-OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-values\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003cp\u003eUnemployed/not working\u003c/p\u003e\n \u003cp\u003eEmployed/Currently working\u003c/p\u003e\n \u003cp\u003ePensioners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003cp\u003e2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003cp\u003e3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eKnowledge about hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eRegular physical exercise\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e2.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eProvince of residence\u003c/p\u003e\n \u003cp\u003eNinh Binh\u003c/p\u003e\n \u003cp\u003eHai Phong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.24\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eTo the best of our knowledge, this study represents one of the pioneering efforts to evaluate both the extent and influencing factors on adoption of SMBP among individuals with hypertension in Vietnam. The findings emphasise that socioeconomic factors, specifically occupation status, patients' understanding of hypertension management, adherence to a healthy lifestyle, and residential location, are significant predictors for the practice of SMBP among hypertensive patients. These findings highlight the importance of targeted interventions to promote SMBP, considering sociodemographic and lifestyle factors to enhance hypertension management and control.\u003c/p\u003e \u003cp\u003eThe study revealed that 43.1% of patients with hypertension regularly self-monitored their blood pressure, with 42.3% doing so daily and 57.7% at least weekly. However, our figure is lower than a previous study conducted among similar populations by Hanh (2017) reporting that 53% of hypertensive patients engaged in home BP monitoring. Globally, engagement in SMBP among patients with hypertension ranged from 9\u0026ndash;75% [\u003cspan additionalcitationids=\"CR28 CR29 CR30 CR31 CR32\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The prevalence of SMBP in our study was identical to the studies from Oman (40%) and Canada (45.9%) while it was lower than in some other countries [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. For instance, in Italy, a multi-centre survey showed that 75% of hypertensive patients practice SMBP at home [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Another study in Pakistan reported notable SMBP engagement at 61.7% [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Conversely, our study surpassed others: in the United States, fewer than 25% of adults with hypertension participated in any home blood pressure monitoring [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Ethiopia had notably lower SMBP prevalence at 8.9%, while Singapore and UK reported 24% and 30%, respectively [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. These international comparisons underscore the variability in SMBP practices among hypertensive populations. While our study provides valuable insights into the prevalence in Vietnam, the observed disparities highlight the influence of cultural, healthcare, and regional factors on self-monitoring behaviours. This discrepancy implies the necessity for context-specific healthcare interventions to enhance SMBP practices and hypertension management.\u003c/p\u003e \u003cp\u003eAlmost 85% of patients with hypertension enrolled in our study were older people. Evidently, older patients are more likely to suffer from NCDs, particularly hypertension, than their younger counterparts [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Previous studies indicated that older people prefer to seek care at the local health facilities, given their limited access to higher-level health facilities due to financial and transportation constraints [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. As aforementioned, our study recruited patients who were managed by local CHSs and district hospitals and over 70% of them were currently treated by these PHC facilities. This can explain the dominant proportion of older people in our study sample. Therefore, the generalisability of the study results in the younger population with hypertension or those managed at higher-level health facilities may be limited. Future studies should consider including a more diverse age group and patients from various healthcare settings to ensure broader applicability of the findings.\u003c/p\u003e \u003cp\u003eThe findings from our study in Vietnam illuminate a compelling association between socioeconomic status, as inferred through occupational status, and the adoption of SMBP practices among patients with hypertension. In our sample, over 75% of patients had their personal income via their pension or employment. Notably, pensioners were 2.2 times more likely to embrace SMBP compared to unemployed individuals, underscoring the potential influence of retired individuals in prioritising their health and actively engaging in blood pressure monitoring. In parallel, currently employed individuals demonstrated a 1.3-fold higher likelihood of SMBP adoption, suggesting that those with active employment may also exhibit a better awareness of the importance of regular blood pressure monitoring. In the current study, over 80% of patients who engaged SMBP used their automated sphygmomanometers at home. Better-off patients were more likely to afford a home-based BP monitoring device than their socioeconomically disadvantaged counterparts. These findings align with studies highlighting the positive correlation between socioeconomic status, particularly employment, and health-seeking behaviours [\u003cspan additionalcitationids=\"CR36 CR37\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Comparisons with other studies in the literature may further elucidate these dynamics, providing a nuanced understanding of how socioeconomic disparities influence the adoption of SMBP across diverse populations and contexts.\u003c/p\u003e \u003cp\u003eThe multivariable regression analysis indicated that patients with a more profound understanding of hypertension management exhibited a significantly higher odds ratio of adopting SMBP, highlighting the pivotal role of knowledge in fostering proactive health behaviours. This finding is in line with a growing body of literature emphasising the importance of health literacy in NCD management, particularly self-management of hypertension, in Vietnam [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] and other LMICs [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan additionalcitationids=\"CR42\" citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. In an integrative review, the authors concluded that better knowledge about hypertension self-management, such as BP control measures and modifiable risk factors, can play a central role in assisting patients in their self-care practice [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Studies across diverse settings consistently underscore the positive impact of health education and literacy programmes on empowering individuals to actively participate in the management of chronic conditions [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan additionalcitationids=\"CR45 CR46 CR47\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. However, the nuanced contrasts across different contexts also unveil potential variations in the determinants of health literacy and its influence on health behaviours [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Recognising and addressing these contextual differences can inform tailored interventions aimed at improving health literacy and subsequently enhancing the adoption of SMBP practices among patients with hypertension in Vietnam and comparable LMICs. Future research might delve deeper into the specific components of health education that resonate most effectively with diverse populations, ensuring the development of targeted and culturally sensitive interventions.\u003c/p\u003e \u003cp\u003eThe current study identified a positive association between an active lifestyle and proactive disease management practice. Patients who reported engaging in regular physical activities exhibited a significant 1.5 times higher odds of practicing SMBP. This finding supports the existing literature emphasising the prioritization of increased physical activity as a key intervention strategy for self-managing hypertension in Vietnam [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], and LMICs [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan additionalcitationids=\"CR52 CR53 CR54\" citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. It suggests the need for public health campaigns advocating for increased physical activity and highlights the direct link between an active lifestyle and self-monitoring practices.\u003c/p\u003e \u003cp\u003eThis study reveals a compelling association between residential location and the engagement of SMBP practice among patients with hypertension. Specifically, patients residing in Ninh Binh exhibited a significant 1.6 times higher chance of practicing SMBP compared to their counterparts in Hai Phong. In Ninh Binh, a majority of CHSs offered curative services under the social health insurance scheme, leading to 64.5% of patients seeking hypertension treatment at the lowest level of PHC (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Conversely, health insurance-based services were not widely available at the CHSs in urban settings of Hai Phong city. Consequently, the majority of patients resorted to self-medication (37.0%), sought treatment for hypertension at district hospitals or district health centres (27.2%), or higher-level hospitals (12.0%). Previous studies in Vietnam highlighted issues of patient overcrowding in public hospitals, resulting in minimal consultation time and compromised patient counselling quality [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe level of health facility for hypertension treatment can be a factor that influence SMBP. Further analysis with the current survey data shows that the proportion of patients received counselling services (55.6%) at the CHSs were higher than those at the district hospitals (46.2%) during the last periodical medical appointment (as reported in Appendix 4). This finding is consistent with results of a health facility survey among PHC facilities in Vietnam [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. It was revealed that doctors at district hospitals spent less time per consultation and asked fewer questions per patient compared to doctors at CHSs [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. One of possible explanation was that doctors in district hospitals exert lower effort on individual patients because they face heavier caseloads and thus having less time available per patient [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. Integrated evidence from a systematic review suggests that SMBP, when integrated into patient-healthcare professionals' interactions or as part of a complex intervention to promote self-management of hypertension, is more likely to be effective than a single SMBP intervention [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Our study\u0026rsquo;s finding may illustrate how the availability of health insurance-based services at the CHSs in Ninh Binh may contribute to the increased likelihood of SMBP practice among patients with hypertension. This regional disparity may suggest the importance of considering variations in local healthcare settings when designing targeted interventions to promote disease self-management practices among patients with chronic NCDs in Vietnam.\u003c/p\u003e \u003cp\u003eSeveral limitations were acknowledged in the study. The most important is that the outcome measures were self-reported. The use of self-reports for SMBP practice is common, and, in this study, respondents were carefully assessed with a set of questions. Similar methods have been used in other studies [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Furthermore, it is crucial to recognise that the predominant representation of older patients in the study sample may impose constraints on the generalisability of the findings to the broader population with hypertension in Vietnam. Although hypertension is commonly associated with older age, the skewed age distribution should be considered when interpreting the study's applicability to a more age-diverse population.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eOur study provides important insights into the adoption and contributing factors of SMBP practices among hypertensive patients in Vietnam, an LMIC context where hypertension self-management remains suboptimal. With less than half of patients engaging in SMBP, there is a clear need to scale up this practice to improve hypertension control. Our findings underscore the role of knowledge, socioeconomic status, and healthcare service availability in facilitating SMBP, suggesting that interventions should prioritize vulnerable populations with limited resources. Efforts should focus on making SMBP devices more affordable through subsidies or market-based strategies, improving accessibility through community health programs, and strengthening the capacity of primary healthcare providers to educate and support patients in self-monitoring. A comprehensive, patient-centred approach that addresses financial and knowledge barriers can enhance SMBP adoption, ultimately improving hypertension management and reducing the burden of cardiovascular diseases in Vietnam.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical clearance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the implementation of the study was granted by the Health Research Ethics Committee of the Hanoi School of Public Health on 13th November 2019, the number 019-485/DD-YTCC. All participants received an explanation of the objectives of the research and the interview process. Written informed consent was obtained from each respondent before the survey.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll contributing Authors give their consent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdditional data are available in additional files and the raw data on which this publication is based, are available from the corresponding author on request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare having no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe SUNI-SEA research project was funded by the European Union\u0026rsquo;s Horizon 2020 research and innovation programme, call SC1-BHC-16-2018 Global Alliance for Chronic Diseases (GACD) - Scaling-up of evidence-based health interventions at population level for the prevention and management of hypertension and/or diabetes, soliciting for research in Low- and Middle-Income Countries (LMIC), under grant agreement No:825026. The funding source was not involved in the data collection, data analysis, manuscript writing and publication.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualisation: NHG, NTPL, JK\u003c/p\u003e\n\u003cp\u003eData collection: NHG, NTPL, LTKA, TNT\u003c/p\u003e\n\u003cp\u003eData analysis: NHG, NTPL, DP, VR, JK\u003c/p\u003e\n\u003cp\u003eArticle production and review: NHG, NTPL, LTKA, DP, VR, TNT, JK\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank all health professionals in the selected health facilities in Vietnam, who contributed voluntarily to this research for their time and devotion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding/Acknowledgements/Conflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work has been supported by the European Union under the research and innovation programme [grant agreement No:825026], call SC1-BHC-16-2018 Global Alliance for Chronic Diseases (GACD) - Scaling-up of evidence-based health interventions at population level for the prevention and management of hypertension and/or diabetes, soliciting for research in Low- and Middle-Income Countries (LMIC). The funding source was not involved in the data collection, data analysis, manuscript writing and publication. All authors made a critical contribution to the process of conceptualisation, data collection, analysis and writing up of the results.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization, \u003cem\u003eGuideline for the pharmacological treatment of hypertension in adults\u003c/em\u003e. 2021, Geneva: World Health Organization.\u003c/li\u003e\n\u003cli\u003eInstitute for Health Metrics and Evaluation. \u003cem\u003eHigh systolic blood pressure\u0026mdash;Level 2 risk\u003c/em\u003e. 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Minh, \u003cem\u003eRelationships between Hypertension knowledge, Self-efficacy, Treatment beliefs and Self-management behaviors among uncontrolled hypertension patients in Da Nang city, Vietnam*.\u003c/em\u003e Journal of Nursing Science and Health, 2020. \u003cstrong\u003e43\u003c/strong\u003e(4): p. 59-71.\u003c/li\u003e\n\u003cli\u003ePham, V., et al., \u003cem\u003eFactors Related to Self-Management Behaviours in Hypertensive Older Adults in Haiduong Province, Vietnam.\u003c/em\u003e Journal of Nursing and Health Sciences, 2016. \u003cstrong\u003e10\u003c/strong\u003e(3).\u003c/li\u003e\n\u003cli\u003eMaginga, J., et al., \u003cem\u003eHypertension control and its correlates among adults attending a hypertension clinic in Tanzania.\u003c/em\u003e The Journal Of Clinical Hypertension, 2016. \u003cstrong\u003e18\u003c/strong\u003e(3): p. 207-216.\u003c/li\u003e\n\u003cli\u003eNiriayo, Y.L., et al., \u003cem\u003ePractice and predictors of self-care behaviors among ambulatory patients with hypertension in Ethiopia.\u003c/em\u003e PLoS One, 2019. \u003cstrong\u003e14\u003c/strong\u003e(6): p. e0218947.\u003c/li\u003e\n\u003cli\u003eIrwan, A.M., et al., \u003cem\u003eSelf-Care Management for Hypertension in Southeast Asia: A Scoping Review.\u003c/em\u003e Journal of Multidisciplinary Healthcare, 2022. \u003cstrong\u003e15\u003c/strong\u003e(null): p. 2015-2032.\u003c/li\u003e\n\u003cli\u003eHa, D.A., et al., \u003cem\u003eConquering hypertension in Vietnam-solutions at grassroots level: study protocol of a cluster randomized controlled trial.\u003c/em\u003e Trials, 2020. \u003cstrong\u003e21\u003c/strong\u003e(1): p. 985.\u003c/li\u003e\n\u003cli\u003eKhuong, Q.L., et al., \u003cem\u003eEffect of community-based intervention on self-management of blood pressure among hypertensive adults: findings from the Communities for Healthy Hearts Quasi-experimental Study in Vietnam.\u003c/em\u003e J Glob Health Sci, 2020. \u003cstrong\u003e2\u003c/strong\u003e(1).\u003c/li\u003e\n\u003cli\u003eShahaj, O., et al., \u003cem\u003eSupporting self-management for people with hypertension: a meta-review of quantitative and qualitative systematic reviews.\u003c/em\u003e J Hypertens, 2019. \u003cstrong\u003e37\u003c/strong\u003e(2): p. 264-279.\u003c/li\u003e\n\u003cli\u003eJafar, T.H., et al., \u003cem\u003eMulticomponent intervention versus usual care for management of hypertension in rural Bangladesh, Pakistan and Sri Lanka: study protocol for a cluster randomized controlled trial.\u003c/em\u003e Trials, 2017. \u003cstrong\u003e18\u003c/strong\u003e(1): p. 272-272.\u003c/li\u003e\n\u003cli\u003ePardoel, Z.E., et al., \u003cem\u003eCore health-components, contextual factors and program elements of community-based interventions in Southeast Asia \u0026ndash; a realist synthesis regarding hypertension and diabetes.\u003c/em\u003e BMC Public Health, 2021. \u003cstrong\u003e21\u003c/strong\u003e(1): p. 1917.\u003c/li\u003e\n\u003cli\u003eMinh, B.C.A., et al., \u003cem\u003eĐ\u0026aacute;nh gi\u0026aacute; thay đổi tu\u0026acirc;n thủ một số biện ph\u0026aacute;m kiểm huyết \u0026aacute;p kh\u0026ocirc;ng d\u0026ugrave;ng thuốc của người bệnh tăng huyết \u0026aacute;p điều trị ngoại tr\u0026uacute; tại bệnh viện đa khoa tỉnh Nam Định.\u003c/em\u003e Khoa học Điều dưỡng, 2020. \u003cstrong\u003e3\u003c/strong\u003e(2): p. 86-93.\u003c/li\u003e\n\u003cli\u003eHoa, L.T., et al., \u003cem\u003eN\u0026acirc;ng cao h\u0026agrave;nh vi tăng cường sức khỏe của người bệnh tăng huyết điều trị ngoại tr\u0026uacute; tại phương Đồng Quang, th\u0026agrave;nh phố Th\u0026aacute;i Nguy\u0026ecirc;n.\u003c/em\u003e Tạp ch\u0026iacute; Khoa học v\u0026agrave; C\u0026ocirc;ng nghệ, 2018. \u003cstrong\u003e177\u003c/strong\u003e(01): p. 135-140.\u003c/li\u003e\n\u003cli\u003eGlynn, L.G., et al., \u003cem\u003eInterventions used to improve control of blood pressure in patients with hypertension.\u003c/em\u003e Cochrane database of systematic reviews, 2010. \u003cstrong\u003e17\u003c/strong\u003e(3).\u003c/li\u003e\n\u003cli\u003eTreciokiene, I., et al., \u003cem\u003eHealthcare professional-led interventions on lifestyle modifications for hypertensive patients\u0026ndash;a systematic review and meta-analysis.\u003c/em\u003e BMC family practice, 2021. \u003cstrong\u003e22\u003c/strong\u003e(1): p. 1-15.\u003c/li\u003e\n\u003cli\u003eXiao, J., et al., \u003cem\u003eEffectiveness of Lifestyle and Drug Intervention on Hypertensive Patients: a Randomized Community Intervention Trial in Rural China.\u003c/em\u003e Journal of General Internal Medicine, 2020. \u003cstrong\u003e35\u003c/strong\u003e(12): p. 3449-3457.\u003c/li\u003e\n\u003cli\u003eSutipan, P., et al., \u003cem\u003eEffects of self-management program on healthy lifestyle behaviors among elderly with hypertension.\u003c/em\u003e International Journal of Behavioral Science, 2018. \u003cstrong\u003e13\u003c/strong\u003e(2): p. 38-50.\u003c/li\u003e\n\u003cli\u003ePutri, S.E., E. Rekawati, and D.N.K. Wati, \u003cem\u003eEffectiveness of Self-Management on Adherence to Self-Care and on Health Status among Elderly People with Hypertension.\u003c/em\u003e Journal of Public Health Research, 2021. \u003cstrong\u003e10\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eNguyen, M.P., et al., \u003cem\u003eWhy do consumers choose private over public health services? Reflective accounts of health providers in Vietnam.\u003c/em\u003e BMC Health Services Research, 2023. \u003cstrong\u003e23\u003c/strong\u003e(1): p. 900.\u003c/li\u003e\n\u003cli\u003eTran, T.Q., et al., \u003cem\u003eNationwide survey of patients\u0026rsquo; and doctors\u0026rsquo; perceptions of what is needed in doctor - patient communication in a Southeast Asian context.\u003c/em\u003e BMC Health Services Research, 2020. \u003cstrong\u003e20\u003c/strong\u003e(1): p. 946.\u003c/li\u003e\n\u003cli\u003eThe World Bank, \u003cem\u003eQuality and Equity in Basic Health Care Services in Vietnam: Findings from the 2015 Vietnam District and Commune Health Facility Survey\u003c/em\u003e. 2016, The World Bank: Washington.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"self-monitoring of blood pressure, hypertension, primary healthcare, Vietnam, chronic disease management, self-care practices","lastPublishedDoi":"10.21203/rs.3.rs-6210921/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6210921/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHypertension is an increasing health problem in low- and middle-income countries (LMICs) such as Vietnam. Self-monitoring of blood pressure (SMBP) is a crucial component of hypertension management in primary healthcare (PHC) and stimulated by healthcare providers. Yet, its adoption remains suboptimal. This study examines the application and contributing factors to adoption of SMBP among hypertensive patients in a PHC setting in Vietnam.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted among 989 hypertensive patients managed at commune health stations (CHSs), part of PHC, in two provinces in Vietnam. Data were collected through structured interviews and analysed using descriptive statistics and multivariate logistic regression to identify factors contributing to SMBP practices.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe prevalence of SMBP among hypertensive patients was 43.1%. Among those who practiced SMBP, 42.3% monitored their blood pressure daily, while 57.7% measured it at least weekly. The majority (80.2%) used home sphygmomanometers, 12% relied on friends or relatives with BP monitoring devices, 7.8% went to a pharmacy of health worker\u0026rsquo;s home to measure BP. Multivariate analysis identified key factors associated with SMBP adoption. Higher educated persons were more engaged in SMBP (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Pensioners were more likely to engage in SMBP than unemployed individuals (OR\u0026thinsp;=\u0026thinsp;2.2; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Higher knowledge of hypertension management (OR\u0026thinsp;=\u0026thinsp;1.10; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and regular physical activity (OR\u0026thinsp;=\u0026thinsp;1.54; p\u0026thinsp;=\u0026thinsp;0.005) were also positively associated with SMBP practice. Persons living in Ninh Bing were also more likely to apply SMBP (OR\u0026thinsp;=\u0026thinsp;1.58; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eLess than half of hypertensive patients practiced SMBP, highlighting a need for targeted interventions to promote self-monitoring. Key facilitators include better health knowledge, socioeconomic stability, and local healthcare service availability. Strategies to improve SMBP adoption should focus on increasing patient education, ensuring the affordability of BP monitoring devices, and strengthening the role of primary healthcare providers in coaching patients on SMBP. A patient-centred, community-based approach is necessary to enhance hypertension self-management and improve overall cardiovascular health outcomes in Vietnam.\u003c/p\u003e","manuscriptTitle":"Factors influencing Adoption of Self-Monitoring of Blood Pressure among Hypertensive Patients in Primary Healthcare in Vietnam: A cross-sectional facility-based study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-01 10:38:08","doi":"10.21203/rs.3.rs-6210921/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-11T11:35:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-10T08:34:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"245022543688653771861361102246368217524","date":"2025-03-31T04:18:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-27T09:11:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"117261986478160087219288892810269697202","date":"2025-03-25T14:39:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317475478035242354618110285277541287501","date":"2025-03-23T14:02:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-23T12:56:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-17T11:00:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-17T10:58:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Primary Care","date":"2025-03-12T09:43:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"81d70bf9-5ced-40a8-b905-3c96c303b3c5","owner":[],"postedDate":"April 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-26T16:00:50+00:00","versionOfRecord":{"articleIdentity":"rs-6210921","link":"https://doi.org/10.1186/s12875-025-02871-5","journal":{"identity":"bmc-primary-care","isVorOnly":false,"title":"BMC Primary Care"},"publishedOn":"2025-05-21 15:56:59","publishedOnDateReadable":"May 21st, 2025"},"versionCreatedAt":"2025-04-01 10:38:08","video":"","vorDoi":"10.1186/s12875-025-02871-5","vorDoiUrl":"https://doi.org/10.1186/s12875-025-02871-5","workflowStages":[]},"version":"v1","identity":"rs-6210921","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6210921","identity":"rs-6210921","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}