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Disparities/Minority Health

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Knowledge and beliefs about lifestyle changes may contribute to ethnic differences in blood pressure control

Over half of U.S. adults over age 60 suffer from high blood pressure (hypertension), with more ethnic minorities, especially blacks, suffering from high blood pressure than whites. Only 34 percent of all people with hypertension have their blood pressure (BP) controlled to less than 140/90 mm Hg. A new study, supported in part by the Agency for Healthcare Research and Quality (HS10871), links ethnic differences in knowledge and beliefs about lifestyle changes to difficulties in controlling BP among blacks. Blacks tended to see medication as the only way to control BP, whereas whites also saw the importance of diet and exercise changes.

Researchers conducted a telephone survey of 1,503 whites, Hispanics, and blacks 50 years and older to assess ethnic differences in awareness, knowledge, and beliefs about hypertension and their relationship to self-reported BP control. More blacks said they had hypertension (64.2 percent) than Hispanics (44.3 percent) or whites (44.2 percent). Blacks were also significantly more likely to state they knew that blacks were at greater risk for hypertension than whites or Hispanics and often had no symptoms. Blacks and Hispanics were more than twice as likely as whites to claim that medications were the only way to control BP (50.5 and 55.5 vs. 23.3 percent).

Whites were more likely than blacks to state that lifestyle changes (for instance, weight loss, decreased alcohol and tobacco use, less stress, and more exercise) were important to BP control. Those who believed that medications were not the only way to treat BP and who knew that reducing alcohol use can lower BP were over twice as likely to have better BP control.

See "Ethnic difference in older Americans: Awareness, knowledge, and beliefs about hypertension," by Eni C. Okonofua, M.D., Neal E. Cutler, Ph.D., Daniel T. Lackland, Dr.P.H., and Brent M. Egan, M.D., in the July 2005 American Journal of Hypertension 18, pp. 972-979.

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