Factors Associated With Potential Uptake Of An Alternative Hypertension Treatment In Black Americans

Black Americans experience the greatest hypertension prevalence in comparison to other racial or ethnic groups in the United States (US). As such, there is an urgent need to translate effective blood pressure (BP)-lowering therapies into clinical practice for this population. At present, there is no existing work reporting the use of patient data to establish factors that may aid in predicting the uptake of alternative, non-pharmacological BP-lowering therapies for Black Americans with hypertension. PURPOSE: To identify factors that may indicate willingness to use isometric handgrip (IHG) training, an alternative therapy that has proven useful for BP-lowering, in Black Americans with hypertension and derive a preliminary prediction model. METHODS: Retrospective data were analyzed from a subsample of Black Americans with hypertension (N = 299) who presented to one of three Emergency Departments in Detroit, Michigan, US, and completed the IsoMetric-Associated Blood Pressure-Lowering Exercise (MAPLE) Questionnaire. A forward-stepwise binary logistic regression was performed to determine patients’ willingness to try an alternative BP-lowering treatment (e.g., IHG training) according to demographic, clinical, and psychosocial factors. RESULTS: Factors that predicted an individual’s willingness to try an alternative BP-lowering treatment included older age (odds ratio [OR] 1.03, p = 0.01), having a higher perceived life experience with racism (OR 1.05, p = 0.04), and having a previous medical history of hypertension (OR 2.20, p = 0.01). The area under the receiver operator characteristic (ROC) curve for a predictive model based on these factors was 0.67 (95% confidence interval [CI], 0.59 to 0.74). CONCLUSION: We identified several predictive factors that help identify Black Americans with hypertension willing to participate in IHG training. While a predictive model based on these factors showed poor discrimination, incorporation of an easy-to-use tool that can help clinicians identify patients who may be willing to use alternative hypertension therapies could help with implementation and improve individual BP control.