The Relationship Among Health Beliefs, Depressive Symptoms, Medication Adherence, and Social Support in African Americans With Hypertension

Abstract

Background: African Americans are disproportionately affected by hypertension and have lower medication adherence when compared to other racial groups. Antecedent factors such as beliefs surrounding hypertension, the presence or absence of social support, and depressive symptoms have not been extensively studied collectively in relation to hypertension medication adherence in African Americans. Objective: To determine the associations among demographic and clinical factors, depressive symptoms, hypertension beliefs, and social support with blood pressure medication adherence in middle-aged African American adults with a diagnosis of hypertension. Methods: A cross-sectional study of (N = 120) African Americans (mean age, 49 years; 22.5% men) with a current diagnosis of metabolic syndrome, including hypertension, who reported having and taking a prescribed blood pressure–lowering medication were included. Descriptive statistics, bivariate correlation analysis, and logistic regression using odds ratio were used to examine the effects of high blood pressure beliefs, social support, and depression on medication adherence. Results: A small but significant relationship was found between medication adherence and number of comorbidities (r = 0.19, P = .04). In a multivariate regression model, after controlling for gender, comorbidities remained associated with medication adherence (β = 0. 77, P = .04). Depressive symptoms, high blood pressure beliefs, and social support did not have a significant relationship with medication adherence. Conclusions: Multiple comorbidities may have a positive impact upon medication adherence. Further study is needed in a larger sample of African Americans who have a diagnosis of hypertension in addition to other comorbidities requiring medication management.

The association between social support and medication adherence in patients with hypertension: A systematic review

“…However, two cross sectional studies found no significant associations between family support and medication adherence. 10,28 In one study (Adisa et al, 2017) family support was mentioned as the most accessible support, while the financial support was the most desired even though no significant association with medication adherence was reported.…”

“…Fourteen studies evaluated the impact of social support on medication adherence; ten cross-sectional studies and four interventional studies. 8,10,[22][23][24][25][26][27][28][29][30][31][32] The cross-sectional studies included in this study used different scales and questionnaires to measure social support as shown in Table 3, while in the interventional studies, family members, friends or pharmacists were designated as supervisors of hypertensive patients. Family members or friends educated patients about the illness and medications, reminded them Figure 1.…”

“…In contrast with the previous findings, two cross-sectional studies in this review found no association of between family support and medication adherence. 10,28 In addition, both financial and healthcare system support was not consistently associated with medication adherence.…”

Investigating Relationships Between Hypertension, Sleep, and Cognitive Risk in an Underserved Community

“…This was a surprising finding, because 81% of the participants were African Americans, which typically face a higher risk for hypertension. Deaths due to high blood pressure in the US are the greatest among African Americans (Spikes et al, 2019). Studies have shown that there are genetic and sociocultural risk factors for hypertension (Fuller, McCarty, Seaborn, Gravlee, & Mulligan, 2018).…”

The relationship between medication adherence, health literacy and social support network in the hypertensive emergency department patient

“…With studies dating back into the late 1950s, researchers have recognized the influence of social support on the ability to adhere to medications for chronic health conditions (Adisa et al, 2017;Berkman & Syme, 1979;Mill, 2019;Shallcross et al, 2017). However, despite the agreement that social support is an important determinant of adherence, its exact role remains debated (Lu et al, 2019;Spikes et al, 2019;Wu & Sheng, 2019).…”