Online Program

Examining the relationship between hypertension self-care activities and blood pressure in a primary care setting

Monday, November 4, 2013 : 2:30 p.m. - 2:42 p.m.

Jan Warren-Findlow, PhD, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
Michael Dulin, MD PhD, Department of Family Medicine, Carolinas Healthcare System, Charlotte, NC
Hazel Tapp, PhD, Department of Family Medicine, Carolinas HealthCare System, Charlotte, NC
Lindsay Kuhn, MHS, PA-C, Department of Family Medicine, CMC-Elizabeth Family Medicine, Charlotte, NC
Assessment of individuals' hypertension self-care activities may provide important information to clinicians and practitioners working to control high blood pressure. The Hypertension Self-Care Activity Level Effects (H-SCALE) measures the six recommended self-care activities: medication adherence; smoking cessation; weight maintenance; healthy diet; alcohol reduction and engagement in physical activity. We assessed patients' self-care activities and then abstracted blood pressure from their medical record. Unadjusted and adjusted partial correlations were performed to examine the relationships between hypertension self-care scores and systolic and diastolic blood pressure (SBP/DBP). We anticipated that scores indicating better self-care would be correlated with lower SBP and DBP. Patients were recruited from a primary care clinic. Participants had hypertension (n=154), were 79% Black, 69% women, with an average age of 55. For five of six self-care scales, correlations between the H-SCALE scores and blood pressure were in the expected direction. After adjusting for demographics, other health conditions, and the other self-care behaviors, medication adherence was significantly correlated with SBP (r=-0.19, p <.05) and weight management was significantly correlated with DBP (r=-0.22, p<.05). Diet scale scores were consistently and significantly correlated with SBP and DBP but not in the expected direction. Valid and reliable self-report measures for hypertension self-care are essential to further our understanding of activities related to blood pressure control. Our results suggest that in general the H-SCALE scores are theoretically in the same direction with blood pressure. Additional research on the diet scale is ongoing in an effort to improve item understanding and discriminatory capabilities.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe components of the H-SCALE measure Discuss H-SCALE scores and their associations with blood pressure

Keyword(s): Hypertension, Self-Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this study and analyzed the data. My research is in the area of chronic disease self-care.I am a public health gerontologist and work primarily at the intersection of gerontology, health disparities, and psychosocial influences on health. My work is directly related to helping achieve the Healthy People 2010 goals of extending years of healthy life and reducing racial and ethnic health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.