Walking Intervention in African American Adults With Newly Diagnosed Hypertension

Hypertension is a very common and serious chronic disease, which affects approximately 50 million people in the United States. Defined by systolic blood pressure (SBP) of 140 mm Hg or higher or diastolic blood pressure (DBP) of 90 mm Hg or higher, hypertension increases the risk for adverse cardiovascular and renal outcomes, such as myocardial infarction, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease. Data from as early as the 1960's indicates that the disease disproportionately effects subgroups of the population, with non-Hispanic African Americans having an age-adjusted prevalence of hypertension (32.4%) almost 40% higher than that noted in non-Hispanic whites (23.3%) and Mexican Americans (22.6%). Although hypertension-related mortality seems to be declining among African Americans, it continues to be a problem which disproportionately affects African Americans more than Whites, particularly in younger age groups.

The management of hypertension is of particular importance for primary care providers, due not only to its prevalence but also because it is a modifiable risk factor for cardiovascular diseases. Although, there are a number of medications available for lowering blood pressure, the first step in managing hypertension should be life-style modification, including weight reduction, increased physical activity, and restriction of dietary sodium and alcohol intake.

Walking seems to be one of the safest and simplest exercises for hypertensive patients of all age groups. Combinations of walking, jogging and bicycling have been shown to be effective in managing hypertension, but there are inherent risks associated with strenuous exercises like jogging and bicycling. Additionally, as most hypertensive patients tend to be overweight, jogging may not be an easy exercise for them. The positive effect of brisk walking on hypertension has been demonstrated in postmenopausal women. Despite the recognized importance of finding ways to effectively manage hypertension in African Americans, there is a paucity of studies on the impact of walking in this population. The purpose of this research was to study the impact of walking an extra 30 minutes a day on blood pressure in 25 to 59 year old African Americans with newly diagnosed hypertension.