Interventions for Hypertension In African American Women

Allen, Angela

Background. Hypertension management is the leading indication for primary care visits in the United States. While women are more affected than men, hypertension incidence among African American (AA) women is three times that of white women.  Further, mortality rates from HTN in AA women are 352% higher than Caucasians.  The treatment of hypertension is similar for all demographic groups; yet, fewer than 50% of AA patients achieve blood pressure control.

Aim. The purpose of this evidence based review is to examine hypertension intervention practices for their efficacy in achieving blood pressure control in AA women.

Methods.  An electronic search using the key terms: hypertension, African American women, black women, hypertension treatment and interventions was conducted to identify publications from 2000-2010 in the following databases: Cochrane Library, CINAHL, PubMed and Google Scholar. 60 abstracts were retrieved and further narrowed using the following inclusion criteria: peer-reviewed papers written in the English language that included an intervention for hypertension with African American women that measured blood pressure control as an outcome. A total of seven papers met these criteria.

Findings. In clinical trials with pharmaceutical products, despite availability of medications and higher rates of treatment adherence, AA women demonstrated lower rates of blood pressure control compared to Caucasian women. In intervention studies with lifestyle modifications (diet, exercise), AA women demonstrate lower reductions in blood pressure compared to men and non AA women. Transcendental meditation coupled with medication was more effective in achieving blood pressure control among AA women than a health education intervention paired with medications.  Group interventions achieved greater reductions in blood pressure than individual interventions.

Implications for Nursing Practice. Advanced practice nurses should consider a multiplicative approach that addresses stressors in the management of hypertension in AA women.  Group interventions offer promising opportunities to treat hypertension among women of color.