Hypertension Self-Management Among African American Adults

Hypertension disproportionately affects African Americans, and adequate blood pressure (BP) control remains a challenge. Self-management of hypertension is critical for improving BP control and reducing hypertension-related morbidities.

The objective of this study is to describe hypertension self-management (HTN-SM) behaviors and the relationship between HTN-SM and self-reported BP in middle- to older-aged African American adults.

A cross-sectional correctional design was used, and African Americans 45 years and older were recruited through flyers. Data were collected using self-report surveys, including the Self-Care of Hypertension Inventory, administered via Qualtrics or by telephone interviews.

Participants (N = 142) had a mean age of 63.04 years (SD = 12.0 years). One hundred sixteen (82%) were female and had lived with hypertension for 13.7 years (SD = 11.1 years). For those who could recall their most recent BP (n = 99, 70%), the average systolic BP was 133 (SD = 13.4) and diastolic BP was 80 (SD = 10.7). Thirty-six (36%) participants had BP readings considered stage 2 hypertension (ie, ≥140/90 mm Hg), and 37 (37%) had readings ≥130/80 mm Hg, considered stage 1 hypertension. The mean hypertension self-care maintenance score used to assess HTN-SM was 58.14 ± 16.67; 28% had adequate scores (≥70). Medication adherence, keeping healthcare provider appointments, and eating fruits and vegetables were the most frequent behaviors, whereas asking for low salt, low fat foods, and exercising were the least frequent. Higher hypertension self-care maintenance scores were significantly associated with lower BP readings.

A significant portion of participants had BP considered "uncontrolled" and low self-care maintenance scores. Facilitating HTN-SM is critical for lowering BP; therefore, assessment of HTN-SM is recommended for understanding potential barriers.