Comprehensive examination of the multilevel adverse risk and protective factors for cardiovascular disease among hypertensive African Americans

Antoinette Schoenthaler, Kezhen Fei, Michelle A. Ramos, Lynne D. Richardson, Gbenga Ogedegbe, Carol R. Horowitz

Research output: Contribution to journalArticle

Abstract

This paper describes the multilevel factors that contribute to hypertension disparities in 2052 hypertensive African Americans (mean age 52.9 ± 9.9 years; 66.3% female) who participated in a clinical trial. At the family level, participants reported average levels of life chaos and high social support. However, at the individual level, participants exhibited several adverse clinical and behavioral factors including poor blood pressure control (45% of population), obesity (61%), medication non-adherence (48%), smoking (32%), physical inactivity (45%), and poor diet (71%). While participants rated their provider as trustworthy, they reported high levels of discrimination in the health care system. Finally, community-level data indicate that participants reside in areas characterized by poor socio-economic and neighborhood conditions (eg, segregation). In the context of our trial, hypertensive African Americans exhibited several adverse risks and protective factors at multiple levels of influence. Future research should evaluate the impact of these factors on cardiovascular outcomes using a longitudinal design.

Original languageEnglish (US)
Pages (from-to)794-803
Number of pages10
JournalJournal of Clinical Hypertension
Volume21
Issue number6
DOIs
StatePublished - Jun 2019

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Keywords

  • African American
  • hypertension
  • multilevel framework
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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