The experience of living with hypertension: a narrative analysis

Abstract

Hypertension, an important risk factor for cardiovascular disease, claims about 17.9 million lives every year. There is a largely uncontrolled hypertension epidemic, which results in significant numbers of life-threatening conditions such as myocardial infarction, aneurysm, stroke, end-stage renal disease, congestive heart failure, dementia, and stroke. Adherence to lifestyle modifications and antihypertensive medications is pivotal to hypertension management. Health literacy and social support are germane to medication adherence. The African American population has a disproportionate burden of hypertension. Churches are the livewires of the African American community, advocating multitiered changes that create healthy and supportive living conditions for long-term wellbeing, especially in underserved societies. While many research studies have focused on hypertension, little has been done to explore the illness narratives of African American adults with hypertension. Therefore, the rationale for this narrative study was to generate a deeper understanding of the lived experience and told stories of African American adults with hypertension participating in a faith-based wellness program. Purposeful sampling recruited African American adults (n=15) living with hypertension and participating in a faith-based wellness program. Individual interviews were conducted in person and via Zoom/telephone. Riessman narrative analysis, with the underlying paradigm of social constructionism, was utilized to guide data collection and thematic analysis. Six themes emerged. The overarching theme was self-care behaviors in hypertension management. The main themes were the discovery of the hypertension diagnosis, the realization of hypertension chronicity, the impact of hypertension on everyday life, and social support. Sub-themes were 'Where do I go from here?' and 'social support: not always up for grabs'. Roadblocks to social support included healthcare professionals' historical and current negative attitudes toward people of color. Self-care behaviors played a dominant role in managing hypertension for this group of African American adults who were participating in a faith-based wellness program. Routine medical screenings were critical in the early discovery of hypertension. The chronic nature of hypertension necessitates consistency in lifestyle changes and medication adherence, which may be enhanced by social support and health literacy. Future research should consider the development of interventions that enhance health literacy and social support from the healthcare system, family, and church among African American people living with hypertension.