title: Social adversity experience and blood pressure control following antihypertensive medication use in a community sample of older adults.
abstract: BACKGROUND
  Psychosocial stress is a risk factor for hypertension and has been shown to affect response to treatment for psychiatric illnesses.
  
  
  OBJECTIVE
  We investigate the relationship between a history of social adversity experience and blood pressure control following antihypertensive medication use.
  
  
  METHODS
  A total of 1,186 participants selected from the European Prospective Investigation into Cancer-Norfolk study (531 men and 655 women, aged 42 to 80 years) had attended two health checks at which blood pressure measurements were taken; were taking antihypertensive medication at the second, but not the first health check; and had completed a questionnaire assessment of their social and psychological circumstances which included details of traumatic experiences in childhood and of adverse life events, long-term difficulties, and perceived stress in adulthood.
  
  
  RESULTS
  Experience of recent loss events in adulthood was associated with a smaller reduction in systolic blood pressure after starting hypertension treatment (β = 1.78, 95 % confidence interval 0.15-3.40, per life event), independently of age, sex, preexisting health conditions, cigarette smoking history, alcohol consumption, physical activity, and obesity.
  
  
  CONCLUSIONS
  Results from this study suggest that stress caused by recent losses may be associated with reduced effectiveness of treatment for hypertension. Subject to replication, these findings may help determine the specific physiological mechanisms by which medication treatment effectiveness is affected by stress.
authors.affiliation: International Health Research Group, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK, nwjwainwright@btinternet.com.
authors.forename: Nicholas W J
authors.initials: NW
authors.lastname: Wainwright
authors.forename: Sheldon
authors.initials: S
authors.lastname: Levy
authors.forename: Jose
authors.initials: J
authors.lastname: Pico
authors.forename: Robert N
authors.initials: RN
authors.lastname: Luben
authors.forename: Paul G
authors.initials: PG
authors.lastname: Surtees
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000517:prevention & control; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012931:Social Environment; D013315:Stress, Psychological / Q000150:complications*; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents