title: Depression, substance use, adherence behaviors, and blood pressure in urban hypertensive black men.
abstract: Relationships between depression, alcohol and illicit drug use, adherence behaviors, and blood pressure (BP) were examined in 190 urban hypertensive Black men enrolled in an ongoing hypertension control clinical trial. More than one fourth (27.4%) of the sample scored greater than 16 on the Center for Epidemiological Studies-Depression Scale (CES-D), indicating a high risk of clinical depression. Depression was significantly associated with an increased likelihood of meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for alcohol abuse or dependence (odds ratio = 5.2; 95% confidence interval = 1.897-14.214). The level of depression was significantly correlated with poor medication (r =.301) and poor dietary compliance (r =.164). Both alcohol intake and illicit drug use were significantly correlated with poor dietary compliance (r =.195 and.185, respectively) and smoking (r =.190 and.269, respectively). Although no direct relationship between depression and the level of BP was substantiated by multivariate analysis, findings of descriptive analyses revealed statistically significant associations among depression, substance use, poor adherence, and poor BP outcomes. Given the harsh environment in which a large number of young urban Black men live, the high prevalence of substance abuse might be an attempt to fight off depression. Further in-depth investigation is needed to identify the role of depression and BP control in urban young Blacks in order to construct effective interventions that address their unique needs.
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205-2110, USA. mkim@son.jhmi.edu
authors.forename: Miyong T
authors.initials: MT
authors.lastname: Kim
authors.forename: Hae-Ra
authors.initials: HR
authors.lastname: Han
authors.forename: Martha N
authors.initials: MN
authors.lastname: Hill
authors.forename: Linda
authors.initials: L
authors.lastname: Rose
authors.forename: Mary
authors.initials: M
authors.lastname: Roary
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015142:Baltimore / Q000453:epidemiology; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance / Q000523:psychology*; D012044:Regression Analysis; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000959:Antihypertensive Agents