Low-salt diet adherence in African Americans with hypertension.

Abstract

To identify health and physiological measures, depressive symptoms and locus of control (LOC) in adherence to a low salt (1,500mg sodium), diet in African American (AA) adults with hypertension (HTN). 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. A cross-sectional correlational design. 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 100mm visual analog scale. Standardised tools included Multidimensional Health LOC scale and the Patient Health Question-9 Depression Instrument. 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). Increasing awareness of factors affecting adherence to a low-salt diet is important for clinicians for effective management of HTN in AA adults. 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.