African Americans have the highest prevalence of hypertension, making it a major contributor to the racial/ethnic health disparities. Numerous studies have sought to understand the reasons for the disproportionate rates of premature hypertension-related mortality. Many have concluded that much of the variance related to differential health outcomes cannot entirely be attributed to differences in access to and quality of health care. Patient-physician relationship has emerged as a potential mechanism in the racial disparities in health care. However, little is known about the effect of the patient-physician relationship on hypertension-related outcomes in African Americans. This study will evaluate the impact of patient-physician relationship on medication adherence and blood pressure control among hypertensive African Americans followed in primary care practices. Specifically, the impact of patients' perceptions of physician communication styles as well as the effect of racial/ethnic composition of the patient-physician relationship on medication adherence and blood pressure control will be investigated. Physician communication style will also be tested as a mediating variable between racial/ethnic composition and medication adherence.
