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Stroke-Related Predictors of Hypertension Self-Management Among African American Adults

Dhruvangi P Sharma1, Dawn M Aycock2, Susan J Kelley2

  • 1Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur St. SE., Urban Life Building, Atlanta, GA, 30302-4019, USA. dsharma2@gsu.edu.

Journal of Racial and Ethnic Health Disparities
|October 7, 2025
PubMed

Insights

African Americans with hypertension need better self-management for stroke prevention. Enhancing self-efficacy is key for improving hypertension self-management (HTN-SM) in this population.

Area of Science:

  • Public Health
  • Cardiovascular Health
  • Health Disparities

Background:

  • African Americans (AA) face significant disparities in uncontrolled hypertension and stroke incidence.
  • Hypertension self-management (HTN-SM) is vital for blood pressure (BP) control, yet stroke-related predictors of HTN-SM are understudied in AA.
  • This research addresses the gap by exploring stroke-related factors influencing HTN-SM for primary stroke prevention in middle-aged to older AA.

Purpose of the Study:

  • To examine stroke risk perceptions, knowledge, symptom history, perceived stress, perceived health, and self-efficacy as predictors of HTN-SM in middle-aged to older AA.
  • To identify key factors that can be targeted to improve HTN-SM and reduce stroke risk in this demographic.
  • To apply the Health Belief Model framework to understand HTN-SM behaviors.

Main Methods:

  • Cross-sectional, correlational design utilizing data from 142 AA individuals aged 45 and older in the United States.
  • Data collection through surveys (Qualtrics) and telephonic interviews.
  • Statistical analysis to determine the predictive power of stroke-related variables on HTN-SM scores, controlling for age.

Main Results:

  • The study population had a mean age of 63 years, with an average hypertension duration of 13.7 years.
  • A significant proportion (72%) exhibited inadequate HTN-SM (score < 70), particularly in diet and exercise components.
  • Self-efficacy (β=.42, p=.000) and perceived health (β=-.21, p=.003) were significant predictors of HTN-SM, explaining 34.6% of the variance (R²=.34, p<.001).

Conclusions:

  • Despite self-reported controlled BP, significant deficits in HTN-SM exist among middle-aged to older AA.
  • Improving self-efficacy for hypertension management may be a more effective strategy than solely increasing general stroke awareness for enhancing HTN-SM.
  • Interventions should focus on bolstering self-efficacy to improve self-management behaviors and reduce stroke risk in AA.

Keywords:
African American stroke knowledgeHypertensionSelf-efficacySelf-managementStroke

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