Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study

Butler, Mark J.; Tanner, Rikki M.; Muntner, Paul; Shimbo, Daichi; Bress, Adam P.; Shallcross, Amanda J.; Sims, Mario; Ogedegbe, Gbenga; Spruill, Tanya M.

doi:10.1016/j.jash.2017.06.011

Cited by 30 publications

(20 citation statements)

References 36 publications

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“…Only 43.9% of respondents were certain that their blood pressure is controlled. However, a higher proportion of medication nonadherence was noticed in the uncontrolled blood pressure patients [3,17,18,36]. Poorly controlled or untreated hypertension provokes gradual and irretrievable damage to internal organs, the consequences of which include serious complications or even death.…”

Section: Discussionmentioning

confidence: 99%

Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

et al. 2019

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Background and Objectives: A particular problem in cardiology is poor adherence to pharmacological treatment among patients with hypertension. It is known that approximately half of these patients do not use their medications as prescribed by their doctor. Patients may choose not to follow the doctor’s recommendations and regularly do not control their blood pressure, owing to many factors. A convenient method for measuring the level of adherence is the Morisky Medication Adherence Scale, which also provides insight into possible remedies for low adherence. We investigated their therapy, knowledge about the disease and its control, and demographic differences to assess the adherence of patients with hypertension. Materials and Methods: This was a cross-sectional observational study. Data were collected through a survey of 12 pharmacies in Latvia. The study involved 187 participants with hypertension. Results: The prevalence of non-adherence was 46.20% in Latvia. The oldest patients were the most adherent (p = 0.001, β = 0.27). The higher the self-rated extent from 0 to 10, to which the patient takes their antihypertensives exactly as instructed by their physician, the higher the level of adherence (p < 0.0001, β = 0.38), where at “0”, the patient does not follow physician instructions at all, and at “10”, the patient completely follows the physician’s instructions. Non-adherent patients tend to assess their medication-taking behavior more critically than adherent patients. The longer the patient is known to suffer from hypertension, the more adherent he or she is (p = 0.014, β = 0.19). Conclusions: Medication non-adherence among patients with hypertension is high in Latvia. Further investigations are needed to better understand the reasons for this and to establish interventions for improving patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

et al. 2019

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“…Nonadherence to two aspects of hypertension management, namely prescribed drug regimens and lifestyle recommendations, are the two major challenges that lead to uncontrolled, resistant, and complicated hypertension (heart failure, stroke, and renal failure) [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. There is strong evidence that shows poor adherence to antihypertensive medications is associated with uncontrolled blood pressure among African Americans [ 24 ]. Poor adherence to cardiovascular medications, antihypertensive agents, and statins among older African American adults is also well documented [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is strong evidence that shows poor adherence to antihypertensive medications is associated with uncontrolled blood pressure among African Americans [ 24 ]. Poor adherence to cardiovascular medications, antihypertensive agents, and statins among older African American adults is also well documented [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. For African Americans, poor adherance to antihypertensive medications happens in a context of several other health and medication-related problems.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults

Adinkrah

Bazargan

Wisseh

et al. 2020

IJERPH

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Background: For African American middle-aged and older adults with hypertension, poor adherence to medication and lifestyle recommendations is a source of disparity in hypertension outcomes including higher rates of stroke in this population relative to whites. Aims: To study demographic, social, behavioral, cognitive, and medical predictors of adherence to medication and lifestyle recommendations among underserved African American middle-aged and older adults with hypertension. Methods: This was a community-based cross-sectional survey in South Los Angeles with 338 African American middle-aged and older adults with hypertension who were 55 years or older. Age, gender, continuity of care, comorbidity, financial difficulty, self-rated health, depression, educational attainment, adherence knowledge, and adherence worries were the independent variables. Data was analyzed using linear regression with two outcomes, namely, adherence to medication (measured by the first 9 items of the Blood Pressure Self-Care Scale) and adherence to lifestyle recommendations (measured by the second 9 items of the Blood Pressure Self-Care Scale). Results: There were about twice more females than males, with a total mean age of 70 years (range 55–90 years). Various demographic, social, behavioral, and medical factors predicted adherence to medication but not adherence to lifestyle recommendations. Females with hypertension with higher continuity of care, less financial strain, higher knowledge, less negative general beliefs, and concerns about antihypertensive medications had higher adherence to antihypertensive medications. The presence of depressive symptoms, reduced knowledge, and disease management worries were associated with a reduced adherence to lifestyle recommendations. Conclusions: There seem to be fewer demographic, social, behavioral, cognitive, and medical factors that explain adherence to lifestyle recommendations than adherence to medication in economically disadvantaged underserved African American middle-aged and older adults with hypertension. More research is needed on factors that impact adherence to lifestyle recommendations of African American middle-aged and older adults with hypertension.

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“…The current cross‐sectional study was restricted to 1658 JHS participants at Examination 1 who had genetic ancestry information available, had valid BP data from the baseline study visit, taking at least one class of antihypertensive medication, and self‐reported taking all of their antihypertensive medications within the past 24 hours (Figure ). The 24‐hour self‐reported antihypertensive medication adherence measure has been associated with BP control in the JHS . The JHS protocol was approved by the University of Mississippi Medical Center's Institutional Review Board.…”

Section: Methodsmentioning

confidence: 99%

“…The 24-hour self-reported antihypertensive medication adherence measure has been associated with BP control in the JHS. 13 The JHS protocol was approved by the University of Mississippi Medical Center's Institutional Review Board. The current analysis was approved by the University of Utah's Institutional Review Board.…”

Section: Study Populationmentioning

confidence: 99%

Association of West African ancestry and blood pressure control among African Americans taking antihypertensive medication in the Jackson Heart Study

Tassell

Shimbo

Hess

et al. 2020

J of Clinical Hypertension

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African Americans have a wide range of continental genetic ancestry. It is unclear whether racial differences in blood pressure (BP) control are related to ancestral background. The authors analyzed data from the Jackson Heart Study, a cohort exclusively comprised of self‐identified African Americans, to assess the association between estimated West African ancestry (WAA) and BP control (systolic and diastolic BP < 140/90 mm Hg). Three nested modified Poisson regression models were used to calculate prevalence ratios for BP control associated with the three upper quartiles, separately, vs the lowest quartile of West African ancestry. The authors analyzed data from 1658 participants with hypertension who reported taking all of their antihypertensive medications in the previous 24 hours. WAA was estimated using 389 ancestry informative markers and categorized into quartiles (Q1: <73.7%, Q2: >73.7%‐81.0%, Q3: >81.0%‐86.3%, and Q4: >86.3%). The proportion of participants with controlled BP in the lowest‐to‐highest WAA quartile was 75.2%, 76.1%, 76.6%, and 74.4%. The prevalence ratios (95% CI) for controlled BP comparing Q2, Q3, and Q4 to Q1 of WAA were 1.00 (0.93‐1.08), 1.02 (0.94‐1.10), and 0.99 (0.91‐1.07), respectively. Among African Americans in the Jackson Heart Study taking antihypertensive medication, BP control rates did not differ across quartiles of WAA.

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Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study

Cited by 30 publications

References 36 publications

Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults

Association of West African ancestry and blood pressure control among African Americans taking antihypertensive medication in the Jackson Heart Study

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