Background: Hypertension (HTN), including uncontrolled HTN, is one of the greatest contributors to stroke risk. A Risk Behavior Diagnosis Scale (RBD) was used to assess individual perceptions of stroke including efficacy for managing HTN associated with stroke risk.
Methods: Data came from the 10-year risk factor telephone interview and in-home assessment of REGARDS participants. REGARDS is a national, population-based, longitudinal study of black and white adults ≥ 45 years, enrolled 2003-2007. Participants were asked about agreement with four constructs of RBD: response efficacy (controlling my BP is effective in preventing stroke), self-efficacy (having skills to control my BP to prevent stroke), severity (belief that stroke is extremely harmful), and susceptibility (it is likely I will have a stroke.) Analysis was restricted to 8,269 individuals with self-reported physician-diagnosis of HTN. BP control was defined as SBP < 140 mmHg or DBP < 90 mmHg. Logistic regression was used to examine the association of hypertension control with agreement with each construct, adjusting for demographics, socioeconomic factors, and history of previous stroke.
Results: Of those who reported HTN, 6,799 (82%) had controlled HTN. In the multivariable model, control of BP was strongly associated with agreement with “having the skills to control BP to prevent stroke” (OR = 1.37; 95% CI: 1.13 - 1.66). There were no associations (p > 0.05) between hypertension control and agreement with any other constructs (see table.)
Conclusions: Among persons with self-reported HTN, those who agreed they had the skills to control their blood pressure to prevent stroke were more likely to have their hypertension controlled. Although self-efficacy is difficult to influence, strategies to improve skills and confidence related to BP management may improve BP control.