{
  "abstract": "Objectives To examine demographic, behavioural and clinical determinants of self-rated health (SRH) among Iranian adults with hypertension (HTN), with a particular focus on the association between blood pressure (BP) control and perceived health.Design National cross-sectional analysis of 15 predictors spanning demographic, lifestyle and clinical domains.Setting 2021 Iranian STEPwise Approach to Non-communicable Disease Risk Factor Surveillance, a nationally representative survey.Participants A total of 8812 adults with HTN (mean age 56.97 years; 57% female). Controlled HTN was defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg among individuals on antihypertensive therapy.Primary and secondary outcome measures The primary outcome was SRH, measured on a standard EuroQol-Visual Analogue Scale (0–100).Results Controlled HTN was independently associated with higher SRH scores (β=1.31, 95% CI 0.07 to 2.54). Positive predictors of SRH included male gender (β=4.34, 95% CI 3.38 to 5.31), higher wealth (richest vs poorest: β=5.52, 95% CI 4.06 to 6.97), sufficient physical activity (β=4.38, 95% CI 3.48 to 5.28), healthier diet (β=3.06, 95% CI 1.99 to 4.14) and complementary insurance coverage (β=2.50, 95% CI 0.63 to 4.37). Significant negative predictors included diabetes mellitus (β=–4.23, 95% CI –5.59 to –3.26), dyslipidaemia (β=–3.61, 95% CI –4.62 to –2.59), people who smoke (β=–4.21, 95% CI –5.64 to –2.78) and older age. Notably, antihypertensive medication use showed one of the strongest negative associations with SRH (monotherapy: β=–4.83; combination therapy: β=–5.28), likely reflecting underlying disease severity and treatment burden.Conclusions Better SRH among hypertensive adults was associated with controlled BP, healthier lifestyle patterns and higher socioeconomic status. Conversely, comorbidities, smoking, older age and antihypertensive treatment were linked to poorer perceived health. Integrating SRH screening into HTN management may help identify vulnerable individuals and inform targeted interventions addressing behavioural and socioeconomic determinants of health.",
  "authors": [
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)",
        "School of Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Nazgol Behgam"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)",
        "Department of Biostatistics, School of Allied medical Science, Shahid Beheshti University of Medical Sciences, Tehran, Tehran Province, Iran (the Islamic Republic of)"
      ],
      "name": "Maryam Karimi Ghahfarokhi"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Yosra Azizpour"
    },
    {
      "affiliations": [
        "Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)",
        "Department of Biostatistics and Epidemiology, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Shadi Naderyan Feli"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)",
        "School of Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Soroush Mozafari"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Mojtaba Lotfaliany"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Hamid Reza Tohidinik"
    },
    {
      "affiliations": [
        "Division of Hematology and Oncology, Pediatrics Center of Excellence, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Farzad Kompani"
    },
    {
      "affiliations": [
        "Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Nazila Rezaei"
    },
    {
      "affiliations": [
        "Deputy of Research and Technology, Iran Ministry of Health and Medical Education, Tehran, Tehran Province, Iran (the Islamic Republic of)"
      ],
      "name": "Shirin Djalalinia"
    }
  ],
  "title": "Association of blood pressure control, lifestyle and socioeconomic status with self-rated health in patients with hypertension: a national cross-sectional study",
  "uid": "2231cea1-7ae5-55ef-bd5a-d8702bd2be18"
}