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Comprehensive High Blood Pressure Care for Young Urban Black Men

Martha N. Hill

Martha Hill
Principal Investigator

Purpose 

  1. Enroll inner-city hypertensive black men, with and without controlled BPs, and follow for 24 months

  2. Characterize HBP and lifestyle-related co-morbidities

  3. Measure effects of nurse practitioner-community health worker-physician intervention on BP reduction and other CV health outcomes

  4. Compare this more intensive (MI) intervention to a less intensive (LI) intervention to lower BP

Hypothesis

 Compared to the LI group, the MI group will have significantly

  • lower mean BP
  • greater BP control (< 140/90 mm Hg)
  • higher rates of being in HBP care and taking HBP medication

Meet the Investigators

Method

The ongoing and proposed research are guided by an eclectic conceptual framework that purposefully represents an integration of models, particularly the PRECEDE-PROCEED model (112) used in our prior work.. This approach integrates health education, behavioral change and maintenance principles, culturally sensitive strategies, social action, and social learning theory. It is essential that conceptual approaches to HBP control incorporate economic, psychosocial and behavioral factors individual lifestyles, self-management practices, and long-term adherence to treatment) in relevant ways. We found disparities in cardiac rehabilitation program participation, with women with lower incomes less likely to be referred and to have lower enrollment rates in cardiac rehabilitation and a strong trend for African-American women to be less likely to be referred and enroll. Because almost all patients who have had an acute coronary event—with or without revascularization procedures—will benefit from cardiac rehabilitation, automatic referral systems should be considered to increase utilization and reduce disparities.

Publications

Kim, M.T., Dennison, C.R. Hill, M.N., Bone, L.R., Levine, D.M. (In Press). Relationship of alcohol and illicit drug use with high blood pressure care and control among urban hypertensive black men. Ethnicity and Disease.Allen JK, Benz Scott L, Stewart KS, Young DR. (2004) Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation. Journal of General Internal Medicine, 19(7), 747-753.*

 Kim, M.T., Juan, H.S., Kim, K.B., Hill, M.N. (In Press). Prevalence and Factors associated with HBP in Korean Americans. Ethnicity and Disease.

Mosca, L., Jones, W.K., King, K.B., Ouyang, P., Redburg, R.F., Hill, M.N. (In Press). Awareness, perception and knowledge of heart disease risk and prevention among American women. Articles of Family Medicine. Bone, L.R., Hill, M.N., Stallings, R., Gelber A.C., Barker, A, Baylor, I., Harris, E.C., Zeger, S.L., Felix- Aaron, K.L., Clark, J.M., Levine, D.L. (2000). Community health survey in an urban African-American neighborhood: Distribution and correlates of elevated blood pressure. Ethnicity & Disease 10, 87-95.

Roary, M.C., Hill, M.N., Bone, L.R., Levine, D.M. (2000). Innovative strategies that dispel the myths about young urban black men with high blood pressure. Cardiovascular Reviews & Reports, 2000;21:129-137.

Hill, M.N., Bone, L.R., Kim, M.K., Miller, D.J., Dennison, C.R., Levine, D.M (1999). Barriers to hypertension care and control in young urban black men. American Journal of Hypertension 12, 951-958.

Hill, M.N., Bone, L.R., Roary, M.C., Hilton, S.C., Kelen, G., Levine, D.M., (1999) A clinical trial to improve HBP care in young urban African American men. American Journal of Hypertension 12, 548-554.

Yanek, L.R., Becker, D.M., Moy, T.F., Blumenthal, R.S., Rquueno, J.V., Yook, R.M., Hill, M.N., Becker, L.C. (1998) Hypertension among siblings of persons with premature coronary heart disease. Hypertension, 32, 123-128.

Fitzgerald, S.T., Hill, M.N., Santamaria, B., Howard, C. & Jadack, R.A. (1997) Nurses' perceptions of consensus reports containing recommendations for practice. Nursing Outlook.45, 229-235.

Redman, B. K., Hill, M. N. and Fry, S. (1997). Ethical conflicts reported by certified nephrology nurses (CNNs) practicing in dialysis settings. ANNA Journal, 24 1 23-34.

Redman, B.K. & Hill, M.N. (1997). Studies of ethical conflicts by nursing practice settings or roles. Western Journal of Nursing Research, 19, 243-260.

Chang, S. B. & Hill, M. N. (1996). HIV/AIDS related knowledge, attitudes, and preventive behavior of pregnant Korean women. IMAGE: Journal of Nursing Scholarship, 28, 321-324. 

Hill, M. N., Feldman, H. I., Hilton, S. C., Holecheck, M. S., Ylitalo, M. S., & Benedict, G. W. (1996). Risk of foot complications in long-term diabetic patients with and without ESRD: A preliminary study. ANNA Journal, 23, 381-386. 

Fitzgerald S. T., Hill, M. N., Santamaria, B., Howard, C., & Jadack R. A. (1996). Diagnosis and management of asthma: Occupational health nurses' awareness and use of national consensus guidelines. Journal of the Association of Occupational Health Nurses, 44, 78-83. 

Hill, M. N. & Berk R. A. (1995). Psychological barriers to hypertension therapy adherence: Instrument development and preliminary psychometric evidence. Cardiovascular Nursing, 31, 37-43. 

Hill, M. N., Grossman, R. A., Feldman, H. I., Horowitz, S., & Defoe, D. (1991). Changes in causes of death after renal transplantation, 1966-1987. American Journal of Kidney Diseases, 17, 512-518. 

Hill, M. N. & Weisman, C. S. (1991). Physicians' perceptions of consensus reports. International Journal of Technology Assessment in Health Care, 7, 30-41. 

Hill, M. N., Levine, D. M. & Whelton, P. K. (1988). Awareness, use, and impact of the 1984 Joint National Committee consensus report on high blood pressure. American Journal of Public Health, 78, 1190-1194. 

Weisman, C. S., Celantano, D., Hill, M. N. & Teitelbaum, M. (1986). Pap testing: Opinion and practice among young obstetrician-gynecologists. Preventive Medicine, 15, 342-351. 

Reichgott, M. J., Pearson, S. & Hill, M. N. (1983). The nurse practitioner's role in complex patient management: hypertension. Journal of National Medical Association, 75, 1197-1204. 

Hill, M. N. & Reichgott, M. J. (1979). Achievement of standards for quality care of hypertension by physicians and nurses. Clinical and Experimental Hypertension, 1, 665-684.