Examining the relationship between hypertension self-care activities and blood pressure in a primary care setting

Assessment of individuals' hypertension self-care activities may provide important information to clinicians and practitioners working to control high blood pressure. The Hypertension Self-Care Activity Level Effects (H-SCALE) measures the six recommended self-care activities: medication adherence; smoking cessation; weight maintenance; healthy diet; alcohol reduction and engagement in physical activity. We assessed patients' self-care activities and then abstracted blood pressure from their medical record. Unadjusted and adjusted partial correlations were performed to examine the relationships between hypertension self-care scores and systolic and diastolic blood pressure (SBP/DBP). We anticipated that scores indicating better self-care would be correlated with lower SBP and DBP. Patients were recruited from a primary care clinic. Participants had hypertension (n=154), were 79% Black, 69% women, with an average age of 55. For five of six self-care scales, correlations between the H-SCALE scores and blood pressure were in the expected direction. After adjusting for demographics, other health conditions, and the other self-care behaviors, medication adherence was significantly correlated with SBP (r=-0.19, p <.05) and weight management was significantly correlated with DBP (r=-0.22, p<.05). Diet scale scores were consistently and significantly correlated with SBP and DBP but not in the expected direction. Valid and reliable self-report measures for hypertension self-care are essential to further our understanding of activities related to blood pressure control. Our results suggest that in general the H-SCALE scores are theoretically in the same direction with blood pressure. Additional research on the diet scale is ongoing in an effort to improve item understanding and discriminatory capabilities.