Living with Hypertension: Experiences of Black Men Related to Their Perceptions of the Clinical Encounter at Diagnosis

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study was to increase nursing and interdisciplinary knowledge about the clinical encounter at the time of diagnosis from the perspective of Black males, aged 18 to 44, including how their life experiences at and after diagnosis were influenced by that encounter. The overall aim was to generate knowledge useful in the development of practice interventions that improve outcomes, reduce costs, and decrease health disparities for Black men with HTN.

Method: An interpretive description qualitative method, as developed by Thorne, was used for this study. Semi-structured questions guided data collection during private one-on-one interviews with participants. Data analysis was an inductive process informed by constant comparative analysis.

Findings: The consensus of the 17 participants was that, while healthcare providers were polite and professional the information provided at diagnosis did not meet their needs for managing HTN. Themes identified were denial, fear, and frustration. Most participants believed HTN happens to older people, an assumption that promoted denial of their condition. Knowing loved ones who suffered from HTN related illnesses led to fear when acknowledging their own diagnosis. Participants reported engaging in some health promoting behaviors. However, limited education, support, and motivation often resulted in unmanaged blood pressure and feelings of frustration.

Conclusion: While it is evident that educational opportunities exist during and after diagnosis, the men received little more than confirmation of their condition. As the focus on disease prevention increases, the provision of adequate resources to help Black men manage HTN should become a research priority.