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Apr 10, 2012

Self-Affirmation and Medication Adherence in Hypertensive African Americans

Positive thinking may help with medication adherence more than you might think.

It is well established that more African Americans are affected by hypertension than whites, helping explain a significant racial gap in mortality rates. Uncontrolled, high blood pressure puts increased stress on the heart and greatly increases risk for heart disease, heart attack, stroke and death. To better control hypertension in African Americans, researchers recently tested the use of positive thinking and self-affirmation in helping patients with high blood pressure better adhere to their medications.

This study, published by the Archives of Internal Medicine, enrolled a total of 256 African Americans with high blood pressure. Half of these participants received standard care, including a culturally tailored hypertension self-management workbook, creation of a behavioral contract and bimonthly telephone calls designed to help patients overcome any barriers they might face to medication adherence. The second half of participants were assigned to the intervention group, receiving standard care plus small gifts and bimonthly telephone calls that encourage self-affirmation and positive thinking in patients’ daily routines.

After following both groups of participants for a total of 12 months, researchers found that patients in the intervention group had significantly higher medication adherence than those receiving standard care. And although this improvement in medication adherence did not translate to a significant improvement in blood pressure control, findings are promising. Despite the efficacy of hypertensive medications, if patients fail to adhere to their prescriptions, their blood pressure will not be controlled properly and risk for heart disease, heart attack and stroke will remain high. By incorporating effective interventions, such as positive-affect, to improve medication adherence, patients receive added support that could ultimately lead to better control of chronic conditions, such as hypertension, and improve outcomes.

Questions for You to Consider

  • What does "medication adherence" mean?

  • Medication adherence means taking the proper dose of a drug the correct number of times each day and never adjusting or skipping doses without being advised to do so by a physician. Failing to properly adhere to medications could render drugs ineffective or actually harm the body.
  • Can I control my blood pressure without medication?

  • You can help reduce or control your blood pressure through healthy lifestyle changes—maintaining a healthy weight, eating a heart-healthy diet and exercising regularly. Also, for smokers, quitting smoking can help drastically improve blood pressure and reduce cardiovascular risk. However, for some patients, making these changes may not be enough to properly control blood pressure and medication may be necessary.

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