Prevalence rates of hypertension self-care activities among African Americans

J Natl Med Assoc. 2011 Jun;103(6):503-12. doi: 10.1016/s0027-9684(15)30365-5.


Background: A comprehensive understanding of the self-care activities that contribute to blood pressure control may explain health disparities experienced by African Americans with hypertension. This study assessed the prevalence of self-care activities among African Americans with high blood pressure and examined differences between adherers and nonadherers to self-care activities.

Methods: Interviews were conducted with 186 African Americans. Self-care activities were measured using the H-SCALE (Hypertension Self-Care Activity Level Effects), which was developed to assess the behavioral activities recommended for optimal management of high blood pressure.

Results: More than half of participants reported adhering to medication recommendations and prescribed physical activity levels (58.6% and 52.2%, respectively). Following practices related to weight management was less frequent, (30.1%) and adherence to low-salt diet recommendations was also low (22.0%). Three-fourths were nonsmokers and 65% abstained from alcohol. Across the self-care activities, adherers were more likely to be older and female. Nonadherers were more likely to be uninsured.

Conclusions: Many African Americans still face challenges related to hypertension self-care, particularly with weight management and salt reduction. The H-SCALE was a valid and reliable measure of hypertension self-care activities. In addition to monitoring blood pressure, health care providers should assess patients' hypertension self-care activities using the H-SCALE.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Black or African American
  • Blood Pressure Monitoring, Ambulatory
  • Chronic Disease
  • Cross-Sectional Studies
  • Diet, Sodium-Restricted / ethnology
  • Female
  • Health Behavior / ethnology*
  • Healthcare Disparities / ethnology*
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / ethnology
  • Hypertension* / physiopathology
  • Hypertension* / therapy
  • Male
  • Medication Adherence* / ethnology
  • Medication Adherence* / psychology
  • Middle Aged
  • Motor Activity
  • Prevalence
  • Self Care* / methods
  • Self Care* / psychology
  • Self Care* / standards
  • Socioeconomic Factors
  • Weight Loss


  • Antihypertensive Agents