title: Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence.
abstract: BACKGROUND
  Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for the development of mental health disorders particularly anxiety and depression. For Ghanaian patients with hypertension, the interaction between hypertension and symptoms of anxiety, depression and stress remains largely unexplored. To fill this knowledge gap, the study sought to ascertain the prevalence and role of these negative emotions on anti-hypertensive medication adherence while taking into account patients' belief systems.
  
  
  METHODS
  The hospital-based cross-sectional study involving 400 hypertensive patients was conducted in two tertiary hospitals in Ghana. Data were gathered on patient's socio-demographic characteristics, anxiety, depression and stress symptoms, spiritual beliefs, and medication adherence.
  
  
  RESULTS
  Hypertensive patients experienced symptoms of anxiety (56%), stress (20%) and depression (4%). As a coping mechanism, a significant relation was observed between spiritual beliefs and anxiety (x (2) = 13.352, p = 0.010), depression (x (2) = 6.205, p = 0.045) and stress (x (2) = 14.833, p = 0.001). Stress among patients increased their likelihood of medication non-adherence [odds ratio (OR) = 2.42 (95% CI 1.06 - 5.5), p = 0.035].
  
  
  CONCLUSIONS
  The study has demonstrated the need for clinicians to pay attention to negative emotions and their role in medication non-adherence. The recommendation is that attention should be directed toward the use of spirituality as a possible mechanism by which negative emotions could be managed among hypertensive patients.
authors.affiliation: Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Department of Pharmacy Practice and Clinical Pharmacy, University of Ghana School of Pharmacy, College of Health Sciences, Legon, Ghana.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Kretchy
authors.affiliation: Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Frances T
authors.initials: FT
authors.lastname: Owusu-Daaku
authors.affiliation: Department of Psychology, University of Ghana, Legon, Ghana.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Danquah
keywords: Ghana; Hypertension; Medication non-adherence; Negative emotions; Spirituality