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  1. Abel, Willie M. PhD, RN, ACNS-BC
  2. Barksdale, Debra J. PhD, RN, CFNP, CANP


The prevalence of hypertension in African Americans exceeds that of all other racial/ethnic groups in the world. Hypertension in African Americans is less likely to be controlled and this problem is further complicated by failure to adhere to prescribed hypertension management regimens. Oftentimes, health care providers give African American patients with hypertension multiple health "rules" to follow that may arouse reactance behaviors: that is, patients may choose to do the opposite of what they are told to do. The theory of psychological reactance offers a framework for understanding the relationship between freedom of choice and adherence to hypertension regimens in African Americans.