The association between mHealth wearables and hypertension selfmanagement in African-born immigrants from medically underserved areas in the United States: a causal-comparative study

Background Hypertension remains a major global health concern, increasing the risk of heart disease and stroke. It affects over 1.3 billion adults globally and nearly half the US adult population (47.3%), or 116 million individuals. African-born immigrants (40.2%) are disproportionately affected compared to 30% for other ethnic groups. A significant portion of Americans (67 million) have uncontrolled hypertension. Using mHealth interventions, especially wearable devices, has shown some potential in improving hypertension control and treatment compliance in ethnic minorities. Methods This causal-comparative study conducted in 2024 aimed to determine if there is an association between using mHealth wearable devices and improving hypertension control in African-born immigrant groups. The inclusion and exclusion criteria consisted of having a hypertension diagnosis, being 45-75 years old, reading at a third-grade level, and living in a medically underserved primary care area (MUA). A t-test was used to compare the mean arterial pressure data in two groups. Results All 100 participants from nine MUAs were randomly divided into two equal groups. Group 1 used a smart watch (the mHealth group) to measure their blood pressure, whereas Group 2 (the usual care group) used an automated blood pressure monitor. The study yielded two statistically significant results, including 1) the mean arterial pressure at the end of six weeks was lower in the mHealth group than in the usual care group (p < 0.001) with a -4 mmHg difference. The mHealth group participants achieved a better mean arterial pressure with a -3 mmHg reduction in mean arterial pressure (p = 0.005). Conclusions The study suggested that African-born immigrants can benefit from using mHealth wearable devices to improve hypertension management. It contributed to the understanding of factors associated with the higher prevalence of hypertension among African-born immigrants. It aligns with ongoing efforts to uncover novel approaches for assisting minority populations in low-resource settings to control hypertension using mHealth wearable devices.