Objective To construct an empirical model exploring the impact of health-related internet use on hypertension self-management and provide reference pathways for improving self-management behaviors among middle-aged and elderly hypertensive patients.

Methods A cross-sectional study was conducted. From January 2023 to March 2023, using a multi-stage random sampling method, 12 communities were randomly selected in 4 cities of Hubei Province, and hypertensive patients aged 45 and above were randomly selected in each community as the research subjects. Participants were investigated by using the Health-Related Internet Use Behavior Scale, Hypertension Self-Management Behavior Scale, Hypertension Self-Efficacy Scale, and Hypertension Self-Management Outcome Expectation Scale. SPSS 24.0 was used for descriptive statistics and multiple linear regression analysis. Structural equation modeling (SEM) was established using AMOS 26.0 to explore the effects of health-related internet use, self-efficacy, and outcome expectations on self-management behaviors. Bootstrap analysis was applied to validate mediating effects.

Results A total of 323 middle-aged and elderly hypertensive patients were included, among which 175 cases (54.18%) were male and 148 cases (45.82%) were female. The mean score of health-related internet use was 29.11±8.55, and the self-management behavior score was 78.61±12.12. SEM results revealed that health-related internet use had a direct effect on self-management (β=0.44, P＜0.001), accounting for 45.36% of the total effect. Both self-efficacy and outcome expectations acted as partial mediators in the positive impact of health-related internet use on self-management, with mediating effect values of 0.32 (P＜0.001) and 0.21 (P＜0.001), and mediation proportions of 32.99% and 21.65%, respectively.

Conclusions Health-related internet use among middle-aged and elderly hypertensive patients is at moderate level, while self-management behavior is at upper-middle level. Health-related internet use significantly and positively influences self-management in this population, with self-efficacy and outcome expectations serving as partial mediators.