Factors Associated with Self-Management in African Americans with Hypertension

Abstract

African Americans (AAs) have a higher prevalence of hypertension (HTN) and poorer health outcomes. Effective management of HTN requires pharmacology, low sodium diet (DIET), and increased physical activity (PA). Little is known about self-management of DIET and PA in AAs with HTN. The aim of this study is to examine the influence of factors (systolic blood pressure, co-morbidities, serum potassium and creatinine, education, depression, locus of control (LOC), and social support) on self-management behaviors (DIET, PA). Using a cross-sectional design, AAs with HTN who participated in a recent clinical trial completed instruments to measure the factors. Two multiple linear regression models were used: one including only internal LOC and one with only external LOC. The sample (N = 77) ranged in ages from 55 to 84 (M = 66; SD = 7.68), most were female (n=50; 65%), and had high medication adherence scores (M = 93.8; SD = 9.77). The models explained 28% of the variance in PA (F = 3.361 [8, 68]; p = .003 with depression, serum creatinine, and social support significantly contributing to the internal LOC model and also to the external LOC model (F = 3.378 [8, 68]; p = .003). The same models explained 23% of the variance in adherence to a low sodium diet (F = 2.599 [8, 68]; p = .015) with serum potassium and social support significantly contributing to both models. Findings from this study inform the development of targeted interventions to increase self-management behaviors in AAs with HTN.