Key result
African-American patients with hypertension had approximately 3 times higher odds of intending to exercise in the next 30 days rather than actively exercising for over 6 months compared to white patients.
Cross-Sectional (n=244)
Yes
Odds Ratio: 3
Absolute Event Rate: 36% vs 17%
p-value: p=<0.002
Implementation of exercise as a lifestyle modification for hypertension differs by race, with African-Americans less likely to engage in exercise, potentially related to socioeconomic factors like income.
Racial differences in exercise stages among hypertensive patients warrant no practice change; leaves open socioeconomic drivers and needs prospective confirmation.
BACKGROUND: Hypertension is a major cause of morbidity and mortality in the United States and disproportionately affects African-Americans. A cornerstone to treatment is nonpharmacologic lifestyle modifications. Despite such recommendations, many patients fail to exercise. METHODS: An anonymous survey (n = 285) of hypertensive patients cared for at 2 offices within the Ohio State University Primary Care Practice-Based Research Network. Survey questions included demographics, recommendations for diet, and exercise lifestyle modification for reducing blood pressure. Questions were phrased as multiple choice or based on Prochaska and DiClemente's readiness to change model. RESULTS: Of the 244 respondents, 57% were women and 43% were African-American. The income of African-Americans was significantly lower than that of whites. Exercise and increased fruit/vegetable consumption were the preferred lifestyle modifications and did not differ by race. Race and exercise were associated; a majority of whites were engaged in exercise whereas this was not so for African Americans. CONCLUSIONS: Although exercise as a preferred lifestyle modification habit does not differ by race, implementation of such a behavior does. This may be related to differing income levels. When counseling patients, physicians must be prepared to ask what may hinder the adoption of such behavior and be prepared to offer possible solutions to overcoming such factors.
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Wexler et al. (2008) conducted a cross-sectional in Hypertension (n=244). African-American race vs. White race was evaluated on Odds of choosing intention to exercise in the next 30 days (stage 3) over actively exercising for >6 months (stage 5) (OR ~3, p=<0.002). African-American patients with hypertension had approximately 3 times higher odds of intending to exercise in the next 30 days rather than actively exercising for over 6 months compared to white patients.
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