title: What Is in a Name? How Biomedical Language May Derail Patient Understanding of Hypertension.
abstract: Despite major advances in treating hypertension, >50% of all individuals diagnosed with the condition remain in poor control. A fundamental issue may be that patients may not fully understand the meaning of the term hypertension or its cause, leading to poor adherence to medications and limiting other effective self-management behaviors. We posit that the word hypertension itself may contribute to these misunderstandings, particularly in regards to the role of stress in causing hypertension, which thus suggests stress management as a primary strategy for control. The word hypertension is often interpreted by patients to mean too much tension. In conjunction with cultural framings of stress causing high blood pressure, many patients turn to stress management to control their hypertension. The word hypertension can thus cause patients to think of it as more of a psychological than physiological condition, thus discounting the value of antihypertensive medications and interfering with medication adherence. We therefore suggest that clinicians reconsider the use of the term hypertension and the ways in which they explain the condition to patients. Reorienting the language to the more patient-centered term of high blood pressure may help patients better understand the condition and to more readily embrace the available efficacious therapies.
authors.affiliation: From the Center for Healthcare Organization and Implementation Research (CHOIR)-VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial VA Medical Center, Bedford, MA (B.G.B., N.R.K.); Department of Health Policy and Management, Boston University School of Public Health, Boston, MA (B.G.B.); and Section of General Internal Medicine, Boston University School of Medicine, Boston, MA (N.R.K.). Barbara.Bokhour@va.gov bokhour@bu.edu.
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Bokhour
authors.affiliation: From the Center for Healthcare Organization and Implementation Research (CHOIR)-VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial VA Medical Center, Bedford, MA (B.G.B., N.R.K.); Department of Health Policy and Management, Boston University School of Public Health, Boston, MA (B.G.B.); and Section of General Internal Medicine, Boston University School of Medicine, Boston, MA (N.R.K.).
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Kressin
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007802:Language; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D012646:Self Administration; D012648:Self Care / Q000379:methods*
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensive agents; hypertension; language; medication adherence; patient education as topic