Stroke-Related Predictors of Hypertension Self-Management Among African American Adults.

African Americans (AA) experience significant disparities in uncontrolled hypertension and stroke. Despite hypertension self-management (HTN-SM) playing a crucial role in blood pressure (BP) control, stroke-related factors as predictors of HTN-SM remain unexplored in this population. This study examined stroke-related theoretical variables-stroke risk perceptions, stroke knowledge, history of stroke symptoms, perceived stress, perceived health, and self-efficacy for managing hypertension-as predictors of HTN-SM for primary stroke prevention in middle-aged to older AA. Using a cross-sectional, correlational design guided by the Health Belief Model, AA 45 years and older were recruited from the United States. Data were collected via surveys administered through Qualtrics or telephonic interviews. Participants (N = 142) had a mean age of 63 years (SD = 12.0) and an average hypertension duration of 13.7 years (SD = 11.1). Among those recalling their last BP reading (n = 99; 70%), the mean systolic BP was 133 mmHg (SD = 13.4), and diastolic was 80 mmHg (SD = 10.7). The mean HTN-SM score was 58.1 (SD = 16.7); 72% scored < 70, indicating inadequate HTN-SM. Deficits in HTN-SM were related to diet and exercise. Participants reported low-moderate stroke risk perceptions, moderate stroke knowledge, low-moderate perceived stress, fair/good perceived health, and inadequate self-efficacy. The model explained 34.6% of the variance in HTN-SM (R² = .34, p = < .001); self-efficacy (β = .42, p = .000) and perceived health (β = -.21, p = .003) were significant predictors, controlling for age. Although most participants self-reported BP readings considered controlled, there were HTN-SM deficits. Enhancing self-efficacy for managing hypertension may be more effective for improving self-management behaviors than solely increasing overall stroke awareness in AA.