Neural Processing of Health Information and Hypertension Self-Management in African Americans

Abstract

Background: Uncontrolled blood pressure (BP) rates are persistently high among African Americans with hypertension. Although self-management is critical to controlling BP, little is known about the brain-behavior connections underlying the processing of health information and the performance of self-management activities.Objectives: In this pilot study, we explored the associations among neural processing of two types of health information and a set of self-management cognitive processes (self-efficacy, activation, decision-making, and hypertension knowledge) and behaviors (physical activity, dietary intake, and medication taking) and health status indicators (BP, health-related quality of life, anxiety, and depression).Methods: Using a descriptive cross-sectional design, 16 African Americans with uncontrolled hypertension (mean age = 57. 5 years, 68.8% women) underwent functional magnetic resonance imaging to assess activation of two neural networks, the taskpositive network and the default mode network, and a region in the ventromedial prefrontal cortex associated with emotionfocused and analytic-focused health information. Participants completed self-reports and clinical assessments of selfmanagement processes, behaviors, and health status indicators.Results: Our hypothesis that neural processing associated with different types of health information would correlate with selfmanagement cognitive processes and behaviors and health status indicators was only partially supported. Home diastolic BP was positively associated with ventromedial prefrontal cortex activation (r = .536, p = .09); no other associations were found among the neural markers and self-management or health status variables. Expected relationships were found among the selfmanagement processes and behaviors and health status indicators.Discussion: To advance our understanding of the neural processes underlying health information processing and chronic illness self-management, future studies are needed that use larger samples with more heterogeneous populations and additional neuroimaging techniques.