title: Strategies to manage hypertension: a qualitative study with black Caribbean patients.
abstract: BACKGROUND
  The detection of hypertension in black Caribbean populations is good, but its control is thought to be inadequate.
  
  
  OBJECTIVE
  To explore how black Caribbean patients with hypertension understand their condition, and the strategies they use in managing hypertension.
  
  
  METHODS
  Qualitative study using in-depth interviews.
  
  
  METHODS
  One general practice in inner-city London.
  
  
  METHODS
  Practice records were searched to identify black Caribbean patients with known and treated hypertension. Audiotaped in-depth interviews were conducted with all identified patients and transcripts of the interviews were analysed for thematic content.
  
  
  RESULTS
  We interviewed 19 black Caribbean patients with hypertension. Participants reported physical symptoms for elevated blood pressure; a minority relied on symptoms to determine their medicine use. A majority of participants equated 'normal' blood pressure readings with being cured and with no need for prescribed medicine. All participants had been prescribed antihypertension medication, and seven reported taking medication as prescribed. Those who did not, reported diverse and dynamic patterns of medication consumption. Some who had achieved normal blood pressure equated this with being cured and stopped medication, resuming when diagnosed with high blood pressure. Some modified their use of tablets according to bodily symptoms that they felt indicated higher or lower blood pressure. Some stopped or reduced medication because of unwanted effects and almost half of the participants used Caribbean 'bush' remedies.
  
  
  CONCLUSIONS
  These findings suggest that some patients are making reasoned decisions about blood pressure management, drawing on medical information, their own bodily experiences of illness and sociocultural notions and practices. However, this may lead to medication use that diverges from that which is recommended. This study indicates a continued need to address these patients' perspectives and develop and evaluate new strategies to achieve hypertension control in this group.
authors.affiliation: Department of Public Health Sciences, King's College London, London. patricia.connell@kcl.ac.uk
authors.forename: Patricia
authors.initials: P
authors.lastname: Connell
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
authors.forename: Charles
authors.initials: C
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001294:Attitude to Health / Q000208:ethnology; D000529:Complementary Therapies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016312:Treatment Refusal; D014900:West Indies / Q000208:ethnology
chemical_list: D000959:Antihypertensive Agents