Therapeutic Lifestyle Changes to Decrease Unhealthy Eating Patterns and Improve Blood Pressure in African Americans

Abstract

Prevention and effective control of high blood pressure is critical, and hypertension management is often diffi cult even with intensive pharmacological therapy. Although the majority of adults with hypertension, over 74 million in the United States, including over two million new cases per year, are given prescription medications to control high levels of blood pressure, many have not reduced their blood pressure to less than 140/90 mmHg [ 17 ]. Shimbo et al. [ 29 ] suggest that once hypertension is resistant, requiring upwards to fi ve antihypertensive agents, nonpharmacological treatment alone is almost always not effective. Nevertheless, the effectiveness of therapeutic lifestyle changes (TLC) can be substantial, with varying estimates for blood pressure reductions with TLC reported in The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines (JNC 7,[ 5 ]). Previous comprehensive reviews have documented the effi cacy of TLC, barriers to lifestyle changes, and strategies to overcome barriers in African Americans [ 25 ]. This previously published comprehensive review of effective TLC for control of blood pressures illustrated the need for systematic coordination of patient, provider, and community roles. Moreover, this report illustrates the relationship of salient factors associated with barriers to behavior change which impact sustained effects of TLC in African Americans.

Exploring Predictors of Information Use to Self-Manage Blood Pressure in Midwestern African American Women with Hypertension

“…38,39 In contrast, other studies conducted in similar samples found that attitude and social norms do influence self-management. 24,25 While it is possible that information behaviors were more important factors in this sample, it is important to note that there was little variance in attitudes and social norms in this sample. Future studies should further evaluate the importance of these concepts among African American women attempting to manage their hypertension.…”

“…5,11,21,22 Patients' attitude towards a behavior, such as management of hypertension, is an important cognitive domain to consider when determining their capacity for self-management. 23-25 Subjective norms, or social pressure that one perceives, is also related to participation in self-management activities. 26 In addition, self-management of hypertension requires that patients learn new information and skills.…”

Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults

“…One of the main purposes of self-management is to enable patients with hypertension to be closely engaged in self-care which is an essential requirement for long-term blood pressure control [ 34 ]. However, the rate of self-management is still considerably low among African American older adults with hypertension [ 35 ] as African Americans have been documented to have low adherence levels to lifestyle recommendations [ 36 , 37 ] and to engage in unhealthy behaviors such as physical inactivity, consumption of high fat and sodium containing foods, and tobacco and alcohol use [ 38 , 39 ]. This supports studies by psychological scientists who have indicated that individuals increasingly struggle with negative behaviors and find it hard to adopt and maintain healthier behaviors [ 40 ].…”