Date of Award
2-15-2024
Publication Type
Thesis
Degree Name
M.H.K.
Department
Kinesiology
Keywords
Black Americans;Blood Pressure Control;Cardiovascular Disease;Clinical Prediction Tool;Hypertension;Isometric Handgrip Training
Supervisor
Cheri McGowan
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide, and its most prominent risk factor, hypertension (HTN; elevated blood pressure; BP) affects 40% of the world’s population. For numerous reasons, including racism and discrimination, limited access to care, low socioeconomic status (SES), lack of knowledge and social support, and low acceptance to traditional treatments, Black Americans in the United States (US) are disproportionately affected. Black Americans experience the highest rates of CVD- related mortality and HTN prevalence compared to any other racial group. Addressing this racial disparity is imperative. Endorsed nationally in HTN guidelines, isometric handgrip (IHG) training is a promising, little- known BP-lowering intervention, that has the potential to improve BP-control in this population. As such, the primary purpose of this study was to derive a preliminary prediction model to be used by clinicians to identify Black Americans with HTN who are most willing to adopt IHG training as a HTN treatment. Baseline retrospective data (2016) was analyzed from a subsample of Black American individuals (N=309) presenting to the Emergency Department at three urban medical centres who completed a questionnaire relating to IHG training acceptability. A forward-stepwise binary logistic regression was performed to determine patients’ willingness to try a new, non-invasive, non-pharmacological, BP-lowering treatment such as IHG training according to demographic, clinical, and self-reported psychosocial factors. Older age (odds ratio [OR] 1.030, p = 0.01), having a higher perceived life experience with racism (OR 1.05, p = 0.045), and having a previous medical history of HTN (OR 2.207, p = 0.016) (n=299) were factors that predicted an individual’s willingness. Future studies should assess the predictive performance of this model in a larger sample followed by robust, randomized control design implementation testing in a clinical setting.
Recommended Citation
De Simone, Kiara, "The Development of a Clinical Predictive Tool to Increase Uptake of a Hypertension Prevention Treatment in at Risk Black Americans" (2024). Electronic Theses and Dissertations. 9440.
https://scholar.uwindsor.ca/etd/9440