Self-monitoring of high blood pressure among hypertensive patients: The role of health beliefs

Approximately 36% of diagnosed hypertensive patients have uncontrolled blood pressure (BP). Evidence suggests that BP self-monitoring improves BP control in hypertensive patients receiving treatment. Although studies have found that certain health beliefs are associated with compliance to medication regimens among hypertensive patients, little is known about factors associated with BP self-monitoring. The purpose of this research was to determine whether beliefs about high blood pressure (HBP) are associated with BP self-monitoring among those with self-reported HBP, while controlling for the effects of sociodemographic factors, health care access and utilization, health status and health behavior. We utilized data from the population-based Dallas Heart Study. We analyzed data from 1440 respondents with self-reported HBP and who were of self-reported Black (n=804), White (n=334) and Hispanic (n=302) ethnicity. The overall response rate was 74%. We constructed measures pertaining to beliefs about one's sense of susceptibility to the consequences of HBP (heart attack, stroke, kidney failure), its symptoms and treatment. BP self-monitoring was reported by 52% of respondents. Self-monitoring was positively associated with a stronger sense of susceptibility to HBP's consequences (OR=1.91, 95%CI=1.28-2.83) and a stronger belief that HBP can be effectively treated with medication and lifestyle modification (OR=2.50, 95%CI=1.52-4.13). In addition, past smokers, compared to never smokers were more likely to self-monitor (OR=1.63, 95%CI=1.01-2.63). Our findings indicate that those who appreciate the dangerous health implications of hypertension are likely to self-monitor. It is possible that stronger beliefs regarding positive action in the form of medication and lifestyle modifications can assist in HBP self-management.