The association between residing in regions with population decline and receiving management education or treatment in patients with hypertension

J Public Health (Oxf). 2025 Jan 7:fdae316. doi: 10.1093/pubmed/fdae316. Online ahead of print.

Abstract

Background: Many districts in rural areas of Korea are facing population decline due to the aging population phenomenon. This study examined the associations of rural residency with the likelihood of receiving hypertension management education and nonpharmacological and pharmacological treatment.

Methods: Data from the 2022 Korea Community Health Survey were used to identify individuals aged 19 years or above diagnosed with hypertension. Rural residency was defined based on the population decline index, which categorizes districts into those with, at risk of, or without population decline. The association between rurality and the likelihood of receiving hypertension management education, with nonpharmacological treatment, and with pharmacological treatment were analyzed using multilevel logistic regression.

Results: Of the 68 183 individuals diagnosed with hypertension, 13 246 (19.4%) received hypertension management education, 17 488 (25.6%) received nonpharmacological treatment, and 65 418 (95.9%) received pharmacological treatment. Individuals residing in areas with population decline were less likely to receive hypertension management education [odds ratio (OR), 0.74; 95% confidence interval (CI), 0.59-0.94] and nonpharmacological treatment (OR, 0.54; 95% CI, 0.42-0.69), but more likely to receive pharmacological treatment (OR, 1.39; 95% CI, 1.17-1.64).

Conclusions: The findings highlight the importance of providing adequate hypertension management education and nonpharmacological treatment to patients residing in rural areas.

Keywords: adults; hypertension; population-based and preventive services.