Objective: The objective was to determine if there was a relationship between adherence and blood pressure (BP) controlling for selected demographics.
Design: A descriptive design was used in this secondary analysis of data from a larger study of ethnic differences in antihypertensive medication adherence.
Sample: Subjects (N=105) at least 35 years old on pharmacological treatment for hypertension were recruited at BP screenings. The sample was 56% (n=59) African American, 71% (n=75) female, 54% (n=57) married, 50% (n=52) employed, late mid-life (M=61.4 years, SD=12.6), well educated (M=13.7 years, SD=2.8), with an income =>$30,000 (55%, n=49), BP of 145/83 (SD=16/11), and hypertension for 12.0 years (SD=11.7).
Methods: BP was taken at enrollment, questionnaires were completed by telephone interview, and medication electronic event monitors were used for 90 days.
Findings: Three adherence measures were used with adherence defined as =>80%. Eighty-six percent were adherent for doses taken, 71% for days adherent, and 53% for optimal intervals. Hierarchical stepwise regression with age, race, years education, and household income entered in the first block and adherence entered in the second block in a forward fashion within blocks showed that doses taken [Change F(1,85)=3.988, Change R-square=.034, p=.049], days adherent [Change F(1,85)=4.898, Change R-square=.041, p=.030], and optimal intervals [Change F(1,85)=8.021, Change R-square=.065, p=.006] explained significant additional variance in diastolic BP but not systolic BP. The full models explained 26%-29% of the variance in diastolic BP.
Conclusions: Between 53% and 86% of subjects were classified as adherent based on the measure used. Older age, Caucasian race, and good adherence were associated with lower diastolic BP.
Implications: Interventions to improve BP control should focus on strategies to improve adherence to antihypertensive medication.
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