Uncontrolled hypertension [HTN] due to poor blood pressure [BP] medication adherence in young and early middle age African American [AA] women is a leading contributor for the sustained hypertension disparities in the US. AA women in the US 20-44 years of age, have the highest prevalence of Hypertension [HTN] when compared to White women of the same age group. Uncontrolled HTN is a significant risk factor for stroke, heart failure, kidney disease, and early mortality, especially in this at-risk group. Barriers prohibiting BP medication adherence have been well characterized across the AA population except in young AA women who bear an unequal and different burden of stressors than older AA women. However, important underlying factors including HTN illness perceptions/representations, unique psychosocial factors including resilient coping, and their influence on good BP medication adherence have not been sufficiently studied among this vulnerable group. Evidence indicating that AAs acquire HTN at younger ages, are less adherent, and are more resistant to treatment compared to other ethnic groups provides a compelling impetus to identify positive and modifiable factors that contribute to BP medication adherence.
The specific aims of this cross-sectional dissertation study are to examine the relationships among sociodemographic & clinical profiles, HTN illness perceptions, and BP medication adherence; and examine the relationships between psychosocial factors, resilient coping style, and BP medication adherence when controlling for sociodemographic factors in a sample of young hypertensive AA women. An exploratory aim will examine the relationship of resilient coping as a potential moderator of high or low adverse stress exposure and its effect on BP medication adherence to elicit understanding of variability in BP medication adherence among this subgroup of hypertensive women. A total of 110 AA women diagnosed with HTN, 18-45 years of age, will be recruited through an ongoing community health heart screening project which is targeting AA women diagnosed with HTN, at-risk for HTN, and other cardiovascular disease risk factors in a large southern urban setting. Descriptive, bivariate correlation, and logistic regression will be used for statistical analysis of the aims. Completion of the proposed study is the first step towards understanding the impact of modifiable factors such as HTN illness perceptions and resilient coping, and their impact on BP medication adherence in this vulnerable population. This study will provide important data to inform development and testing of effective and targeted interventions to reduce HTN disparities while improving health outcomes in a population predisposed to adverse cardiovascular events.
Young and early middle age adult AA women represent a growing group of ethnic minority women diagnosed with hypertension in the United States. This study will examine novel constructs (HTN illness Perceptions and Resilient Coping) and psychosocial factors in relation to hypertension medication adherence to determine their importance in facilitating medication adherence in a population for whom limited information is known regarding factors associated with increased levels of medication adherence. Information gained from this study may advance the field of cardiovascular research and ethnic minority hypertension disparities and may help develop culturally targeted interventions to reduce poor medication adherence, thus improving rates of uncontrolled hypertension in the future.
