Elderly/Long-Term Care

Race and gender affect the likelihood that elderly patients will take their antihypertensive medications

Depending on their race and gender, different factors motivate elderly men and women to take their prescribed antihypertensive medications. Thus, a one-size-fits-all educational program may not be the most effective way to improve medication adherence, suggests Daniel L. Howard, Ph.D., of Shaw University. He and coinvestigators examined antihypertensive medication adherence by a sample of 2,913 elderly hypertensive patients in North Carolina. They collected data in four waves: 1987, 1990, 1994, and 1998 (completed by only 1,470 participants).

Overall, 50.7 percent of white and 59.2 percent of black participants reported currently taking their antihypertensive medication. Both white and black women with higher body mass index (BMI) were more likely to report taking their medication over time. White women who were satisfied with their medical care and black women treated by a minority physician were more likely to take their medication over time.

In contrast, white men with a lower BMI and who were not satisfied with their medical care were less likely to take their antihypertensive medication over time. Also, black men with lower BMI who have white physicians were less likely to take their medication as directed. Black men were 36 percent more likely to take their medication if they had a minority physician or if they were married, 31 percent more likely to do so if they lived in a rural area, and 26 percent more likely to do so if they had controlled blood pressure. Focusing on individual-level characteristics and the different factors that may motivate specific ethnic groups may help to develop more precisely targeted interventions to improve adherence to antihypertensive medication by the elderly, conclude the researchers. The study was supported in part by the Agency for Healthcare Research and Quality (HS13353).

More details are in "Predicting medication use in an elderly hypertensive sample: Revisiting the established populations for epidemiologic studies of the elderly study," by Mimi M. Kim, Ph.D., Dr. Howard, Jay S. Kaufman, Ph.D., and DaJuanicia Holmes, M.S., in the December 2008 Journal of the National Medical Association 100(10), pp. 1386-1393.

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