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Validation of latent health behaviour subtypes in young and middle-aged adults with hypertension: a machine
Qinqin Sun1, Jiahong Tian2, Zhijun Zhang3,4
1Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, No. 99 Longcheng Street, Xiaodian District, Taiyuan 030032, Shanxi, China.
Aims:
To validate behavioural subtypes among young and middle-aged hypertensive patients using latent class analysis (LCA) and assess their generalizability across populations through external validation.
Methods And Results:
We applied LCA to a derivation cohort of 2000 adults with hypertension to classify nine health behaviour indicators. Model robustness was examined with bootstrap stability testing. External validation was conducted in NHANES 2009-2010 (n = 541) using confirmatory LCA. A reproducible three-class solution emerged: Active (32.6%), Selective (28.1%), and Passive (39.3%). Demographic and clinical factors-including age, sex, education, insurance type, adverse medication symptoms, hypertension severity, time since diagnosis, number of medications, and comorbidities-were associated with class membership. Notably, the Passive group showed higher medication adherence (mean 46.4% ± 10.7%), whereas the Selective group had a greater risk of intermittent discontinuation of antihypertensive therapy.
Conclusion:
These findings support the development of individualized intervention strategies targeting health behaviour in young and middle-aged hypertensive patients, providing a scalable framework for stratified hypertension management in diverse populations.
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