Correlates of nonadherence to hypertension treatment in an inner-city minority population.
OBJECTIVE
Adherence to treatment is a key factor in achieving blood pressure control among hypertensives. We examined correlates of nonadherence to hypertension treatment in an inner-city minority population.


METHODS
Subjects (n = 202) were interviewed as part of a case-control study of severe, uncontrolled hypertension conducted in two New York City hospitals in 1989-91. All subjects were African American or Hispanic. Self-reported nonadherence to drug treatment for hypertension was measured using a five-item scale, and the sample was dichotomized as more (n = 87) or less (n = 115) adherent. Multiple logistic regression analysis was used to adjust for demographic and other covariates.


RESULTS
Nonadherence was associated with having blood pressure checked in an emergency room (adjusted odds ratio [OR] = 7.9; 95% confidence interval [CI] = 1.75, 35.77; P < .01), lack of a primary care physician (adjusted OR = 2.9; 95% CI = 1.37, 6.02; P < .01), current smoking (adjusted OR = 2.4; 95% CI = 1.10, 5.22; P = .03), and younger age (adjusted OR = 1.03, 95% CI = 1.00, 1.06; P = .03).


CONCLUSIONS
Changing the locus of care for hypertension from emergency rooms to primary care physicians may improve adherence to hypertension treatment in minority populations.
Shea
S
S
Division of Epidemiology, Columbia University School of Public Health, New York, NY.
Misra
D
D
Ehrlich
M H
MH
Field
L
L
Francis
C K
CK
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D016022:Case-Control Studies; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006786:Hospitals, Urban; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010821:Physicians, Family / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000208:ethnology* / Q000523:psychology; D014505:Urban Population