Performance of hypertension management behaviors by older adults in Georgia senior centers
Allen, Megan Nicole
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High blood pressure continues to be a significant contributor to morbidity and mortality in the United States (Fan et al 2010). Older adults are among the fastest growing segment of the U.S. population and have a high prevalence of hypertension (Lloyd-Jones et al 2005). The increase in the elderly population and prevalence of chronic disease has brought attention towards improving healthcare delivery systems that promote the prevention and management of chronic disease. This study examined the performance of hypertension management behaviors by older adults in senior centers from 12 Georgia Area Agencies on Aging. Participants were a convenience sample (N = 796, mean age = 75.9 years, 81.7% female, 62.6% Caucasian, 73% hypertensive), and participants’ performance of hypertension management behaviors was determined using selected questions from the 2007 - 2008 Live Healthy Georgia questionnaire. The performance of hypertension management behaviors among those with and without hypertension was examined using ANOVA and chi-square analyses. Spearman correlations and logistic regression analyses were used to assess the characteristics associated with performance of hypertension management behaviors and the proportion of older adults performing these behaviors. More African American than white participants reported hypertension (81% vs. 69%). Mean intakes of fruits, vegetables, whole grains and dairy products were 2.2 ± 1.3, 2.8 ± 1.2, 1.6 ± 0.9 and 1.4 ± 1.0 servings per day, respectively. There was no significant difference in fruit and vegetable, whole grain or dairy product consumption between hypertensive and non-hypertensive participants. Compared with non-hypertensive participants, those with hypertension were more likely to reduce salt intake (89.3 vs. 79.7%), but less likely to maintain a healthy body weight (20.3% vs. 38.5%) and engage in physical activity at least 5 days/week (47.4 vs. 57.6%) (all P < 0.05). Better self-reported health and more education were positively associated with performance of more hypertension management behaviors. Being African American was positively associated with reducing salt intake, but negatively associated with performing ≥2 dietary management behaviors. This study is unique because it included a target population of older adults in congregate meals and wellness programs at senior centers in Georgia. The findings of this study can be used to identify hypertension management behaviors and barriers to adherence that need to be targeted to improve the health of older adults and better target Older Americans Act Nutrition Program funding and chronic disease management programs.