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J Natl Med Assoc. 2009 Jun;101(6):597-603.

Barriers to blood pressure control as reported by African American patients.

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Clinical Family Medicine, The Ohio State University, Columbus, Ohio 43210, USA.



To understand African American patients' opinions as to barriers to hypertension treatment.


Focus groups (n=3) were led by a trained African American moderator of African American patients with hypertension (n=26) who receive their care from a large primary care network. Discussions were transcribed verbatim. Information was displayed in a data matrix and analyzed for emerging themes. Descriptive statistics were used to enhance the content validity of lifestyle modification efforts planned as part of this ongoing research.


Most participants were female (n=20), and the mean age was 49 years. All participants were at least high school graduates. Four major levels of influence emerged from data analysis: (1) the health care system, (2) the community, (3) the family, and (4) the individual. The most prevalent concerns about hypertension centered on sodium, diet, neighborhoods, mistrust, and denial. Of great concern was lack of provider trust and a fatalistic, hopeless mindset. To improve trust, our participants suggested developing a hypertension education program and providing patients with culturally specific materials.


Culturally sensitive materials need to be designed and tested to improve blood pressure control. Community input regarding cultural issues is essential for designing effective and successful programs for reducing health disparities.

[Indexed for MEDLINE]

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