Low-salt diet adherence in African Americans with hypertension

J Clin Nurs. 2018 Oct;27(19-20):3750-3757. doi: 10.1111/jocn.14551. Epub 2018 Jul 23.

Abstract

Aims and objectives: To identify health and physiological measures, depressive symptoms and locus of control (LOC) in adherence to a low salt (1,500 mg sodium), diet in African American (AA) adults with hypertension (HTN).

Background: Adherence determinants to self-management behaviours among AA adults with HTN is essential in prevention of outcomes such as stroke. A low-salt diet is one key factor in the successful management of HTN.

Design: A cross-sectional correlational design.

Methods: Systolic blood pressure, co-morbidities, serum creatinine, potassium, education, depression, LOC and social support were examined in relationship to self-reported adherence to a low-salt diet in a sample of AA adults (N = 77) aged 55-84. Demographic and physiologic data were collected in addition to diet adherence on a 100 mm visual analog scale. Standardised tools included Multidimensional Health LOC scale and the Patient Health Question-9 Depression Instrument.

Results: Lower adherence to a low-salt diet was more prevalent in females (n = 27; 73%). A moderate negative correlation (r = -0.294; p < 0.01) was found with low-salt diet adherence in the PHQ-9 (r = -0.294; p < 0.01). Both multiple regression, models significantly influenced adherence to low salt diet, with both models explaining 24% of the variance; internal LOC (F = 2.599 [8, 68]; p = 0.02) and external LOC (F = 2.667 [8, 68]; p = 0.013).

Conclusion: Increasing awareness of factors affecting adherence to a low-salt diet is important for clinicians for effective management of HTN in AA adults.

Relevance to clinical practice: Nurses are encouraged to adopt a comprehensive assessment of those with HTN to identify psychosocial needs, in particular depressive symptoms, as a potential secondary prevention measure.

Keywords: blood pressure; ethnicity; self-management.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data*
  • Blood Pressure
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / prevention & control*
  • Diet, Sodium-Restricted / statistics & numerical data*
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / prevention & control*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Self Report
  • Social Support
  • Stroke / prevention & control