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

Author

Listed:
  • Edward Adinkrah

    (Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA)

  • Mohsen Bazargan

    (Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
    Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90059, USA)

  • Cheryl Wisseh

    (Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
    Department of Pharmacy Practice, West Coast University School of Pharmacy, Los Angeles, CA 90004, USA)

  • Shervin Assari

    (Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA)

Abstract

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.

Suggested Citation

  • Edward Adinkrah & Mohsen Bazargan & Cheryl Wisseh & Shervin Assari, 2020. "Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults," IJERPH, MDPI, vol. 17(18), pages 1-15, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6538-:d:410550
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    References listed on IDEAS

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    1. Cuffee, Y.L. & Hargraves, J.L. & Rosal, M. & Briesacher, B.A. & Schoenthaler, A. & Person, S. & Hullett, S. & Allison, J., 2013. "Reported racial discrimination, trust in physicians, and medication adherence among inner-city African Americans with hypertension," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 55-62.
    2. Two Feathers, J. & Kieffer, E.C. & Palmisano, G. & Anderson, M. & Sinco, B. & Janz, N. & Heisler, M. & Spencer, M. & Guzman, R. & Thompson, J. & Wisdom, K. & James, S.A., 2005. "Racial and Ethnic Approaches to Community Health (REACH) Detroit partnership: Improving diabetes-related outcomes among African American and Latino adults," American Journal of Public Health, American Public Health Association, vol. 95(9), pages 1552-1560.
    3. Christina M. Pettey & Jean C. McSweeney & Katharine E. Stewart & Mario A. Cleves & Elvin T. Price & Seongkum Heo & Elaine Souder, 2016. "African Americans’ Perceptions of Adherence to Medications and Lifestyle Changes Prescribed to Treat Hypertension," SAGE Open, , vol. 6(1), pages 21582440156, January.
    4. Hicken, M.T. & Lee, H. & Morenoff, J. & House, J.S. & Williams, D.R., 2014. "Racial/ethnic disparities in hypertension prevalence: Reconsidering the role of chronic stress," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 117-123.
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