Hypertension management profiles in Chinese adults aged 60 years and older

Background Hypertension control in older adults depends on sustained self-management, yet education strategies often overlook heterogeneity in barriers and capacities. Objective To examine hypertension-related knowledge, behaviors, and educational needs in Chinese adults aged 60 years and older, identify determinants of regular blood pressure (BP) monitoring, and derive management profiles for targeted intervention. Methods A cross-sectional questionnaire survey was conducted among Chinese adults aged 60 years and older recruited from community-based and outpatient clinical settings in Shanghai ( n = 316). Descriptive analyses summarized knowledge, behaviors, barriers, and preferred formats. Multivariable logistic regression identified factors associated with regular BP monitoring. K-means clustering and principal component analysis were used to define management profiles. Results While 76.3% knew the ideal BP range, only 53.2% reported regular monitoring, despite 75.3% owning a home device. Older age predicted lower monitoring likelihood (OR = 0.944 per year, 95% CI 0.901–0.988, p = 0.013). Absence of a home monitor (OR = 0.113, p < 0.001) and lack of knowledge of standardized measurement procedures (OR = 0.212, p < 0.001) were strong negative predictors, whereas conceptual BP knowledge was not. Top education priorities were low-salt diet (69.3%) and older-adult-appropriate exercise (68.0%). Major barriers included information overload (64.6%) and technical terminology (56.6%). Face-to-face consultation was most preferred (81.3%). Five profiles showed marked heterogeneity (all P_FDR < 0.001). The High-knowledge/regular-monitoring profile had the lowest non-regular monitoring (29.2%). The Low-monitoring/low-resource profile had the highest non-regular monitoring (83.6%) and knowledge deficit (27.3%). The Medication-problem profile showed the most adherence problems (37.0%). Conclusion Among Chinese adults aged 60 years and older, regular BP monitoring appears to be influenced more by operational capability than by conceptual awareness. Profile-guided, barrier-aware education may enhance the precision and scalability of hypertension self-management in similar community-based and outpatient care settings. Clinical trial registration https://www.chictr.org.cn/ , ChiCTR2600116499.