Association Between Self-Perception of Aging and Long-Term Mortality in Elderly Patients with Hypertension in Rural China: A Possible Beneficial Effect of Nut Intake

Purpose: Previous research has consistently shown that self-perception of aging (SPA) is an important predictor of health and longevity, while Chinese rural elderly patients with hypertension had poorer SPA. Whether it was associated with their mortality kept unknown. The objective of this study was to investigate the long-term mortality and analyze the association between SPA and this mortality in the specific context of rural elderly patients with hypertension. Patients and Methods: This study is a longitudinal investigation of the mortality in elderly patients with hypertension in rural Suzhou, China. Sociodemographic and clinical data, SPA, and six-year mortality were investigated. We used binary logistic regression and subgroup analyses to assess the effect of SPA at baseline on six-year mortality. Results: A total of 280 hypertensive patients aged 60 years and older participated in the study, of whom 21 died, with a six-year mortality rate of 7.5%. After controlling for covariates, the "Emotional representation" dimension (OR=2.824, 95% CI:1.034-7.712) in SPA remained a risk factor for death. In subgroup analyses of the group aged 75 years and older, high scores on the "Timeline cyclical" (OR=14.125, 95% CI: 1.258-158.593) and "Emotional representations" (OR=2.567, 95% CI:1.066-6.182) dimensions were associated with a higher risk of death, while weekly nut intake may have mitigated the negative SPA effect on mortality. Conclusion: Poorer self-perception of aging was associated with a high risk of mortality in rural elderly patients with hypertension, while the habit of weekly nut intake might help reduce this risk in the group aged 75 years or older.