title: A Systematic Review of Beliefs About Hypertension and its Treatment Among African Americans.
abstract: OBJECTIVE
  The prevalence of hypertension and uncontrolled hypertension is higher among African Americans than any other ethnicity in the USA. Certain patient medical beliefs may lead to adverse health behaviors. The aim of this study was to systematically review and narratively synthesize beliefs about hypertension among African Americans.
  
  
  RESULTS
  In a narrative review of 22 studies, many participants attributed hypertension to stress and fatty foods. Hypertension was perceived to be an episodic, symptomatic disease. Many patients exhibited a strong faith in the efficacy of medications, but used them as needed to treat perceived intermittent hypertensive episodes or infrequently to avoid addiction and dependence. Home remedies were often reported to be used concurrently to treat the folk disease "high blood" or in place of medications associated with unwanted effects. Nevertheless, participants were invested in treatment of hypertension to prevent long-term complications. Trends over time suggest that beliefs about hypertension among African Americans have change significantly and now reflect the currently accepted biomedical model. African American beliefs about hypertension may frequently differ from those of healthcare professionals. These results suggest that reconciliation of differences between patient and provider expectations for disease management may improve adherence to and acceptance of medical treatments among African Americans with hypertension. Nevertheless, discordant health beliefs are common among all patients and additional work to elucidate beliefs of other patient subgroups such as age and gender is warranted.
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, Victoria Johnson Research Laboratories and VCU Pauley Heart Center, Virginia Commonwealth University, 1200 E Broad Street, West Hospital Rm 520, Richmond, VA, 23298, USA. LBuckley2@vcu.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Buckley
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Labonville
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Barr
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D055118:Medication Adherence
keywords: Hypertension in African Americans; Medication adherence; Patient beliefs