The association between mHealth wearables and hypertension selfmanagement in African-born immigrants from medically underserved areas in the United States: a causal-comparative study

Abstract

Background

Hypertension remains a major global health concern, increasing the risk of heart disease and stroke. It affects over

1.3 billion adults globally and nearly half the US adult population (47.3%), or 116 million individuals. African-born

immigrants (40.2%) are disproportionately affected compared to 30% for other ethnic groups. A significant portion

of Americans (67 million) have uncontrolled hypertension. Using mHealth interventions, especially

wearable devices, has shown some potential in improving hypertension control and treatment compliance in ethnic

minorities.

Methods

This causal-comparative study conducted in 2024 aimed to determine if there is an association between using

mHealth wearable devices and improving hypertension control in African-born immigrant groups. The inclusion and

exclusion criteria consisted of having a hypertension diagnosis, being 45-75 years old, reading at a third-grade level,

and living in a medically underserved primary care area (MUA). A t-test was used to compare the mean arterial

pressure data in two groups.

Results

All 100 participants from nine MUAs were randomly divided into two equal groups. Group 1 used a smart watch (the

mHealth group) to measure their blood pressure, whereas Group 2 (the usual care group) used an automated blood

pressure monitor. The study yielded two statistically significant results, including 1) the mean arterial pressure at

the end of six weeks was lower in the mHealth group than in the usual care group (p < 0.001) with a -4 mmHg

difference. The mHealth group participants achieved a better mean arterial pressure with a -3 mmHg reduction in

mean arterial pressure (p = 0.005).

Conclusions

The study suggested that African-born immigrants can benefit from using mHealth wearable devices to improve

hypertension management. It contributed to the understanding of factors associated with the higher prevalence of

hypertension among African-born immigrants. It aligns with ongoing efforts to uncover novel approaches for

assisting minority populations in low-resource settings to control hypertension using mHealth wearable devices.