Racial differences in two self-management hypertension interventions.

dc.contributor.author

Bosworth, Hayden B

dc.contributor.author

Olsen, Maren K

dc.contributor.author

Grubber, Janet M

dc.contributor.author

Powers, Benjamin J

dc.contributor.author

Oddone, Eugene Z

dc.date.accessioned

2024-02-01T20:07:43Z

dc.date.available

2024-02-01T20:07:43Z

dc.date.issued

2011-05

dc.description.abstract

Background

Only one half of Americans have their blood pressure controlled, and there are significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of 2 patient-directed interventions designed to improve blood pressure control within white and non-white subgroups (African Americans, 49%).

Methods

Post hoc analysis of a 2 by 2 randomized trial with 2-year follow-up in 2 university-affiliated primary care clinics was performed. Within white and non-white patients (n=634), 4 groups were examined: 1) usual care; 2) home blood pressure monitoring (3 times per week); 3) tailored behavioral self-management intervention administered via telephone by a nurse every other month; and 4) a combination of the 2 interventions.

Results

The overall race by time by treatment group effect suggested differential intervention effects on blood pressure over time for whites and non-whites (systolic blood pressure, P=. 08; diastolic blood pressure, P=.01). Estimated trajectories indicated that among the 308 whites, there was no significant effect on blood pressure at 12 or 24 months for any intervention compared with the control group. At 12 months, the non-whites (n=328) in all 3 intervention groups had systolic blood pressure decreases of 5.3 to 5.7 mm Hg compared with usual care (P <.05). At 24 months, in the combined intervention, non-whites had sustained lower systolic blood pressure compared with usual care (7.5 mm Hg; P <.02). A similar pattern was observed for diastolic blood pressure.

Conclusion

Combined home blood pressure monitoring and a tailored behavioral phone intervention seem to be particularly effective for improving blood pressure in non-white patients.
dc.identifier

S0002-9343(11)00018-0

dc.identifier.issn

0002-9343

dc.identifier.issn

1555-7162

dc.identifier.uri

https://hdl.handle.net/10161/30097

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

The American journal of medicine

dc.relation.isversionof

10.1016/j.amjmed.2010.11.024

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

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Hypertension

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Antihypertensive Agents

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Blood Pressure Monitoring, Ambulatory

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Self Care

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Health Behavior

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Life Style

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Research Design

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Telephone

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Adult

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Aged

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Middle Aged

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United States

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Female

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Male

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Health Status Disparities

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Confounding Factors, Epidemiologic

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Black or African American

dc.title

Racial differences in two self-management hypertension interventions.

dc.type

Journal article

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

duke.contributor.orcid

Olsen, Maren K|0000-0002-9540-2103

pubs.begin-page

468.e1

pubs.end-page

468.e8

pubs.issue

5

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Biostatistics & Bioinformatics

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

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Biostatistics & Bioinformatics, Division of Biostatistics

pubs.publication-status

Published

pubs.volume

124

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