Bandi Priti, Goldmann Emily, Parikh Nina S, Farsi Parisa, Boden-Albala Bernadette
College of Global Public Health, New York University, 665 Broadway, 11th Floor, New York, NY 10003. Email:
College of Global Public Health, New York University, New York, New York.
Prev Chronic Dis. 2017 Jul 13;14:E57. doi: 10.5888/pcd14.160512.
US Hispanics, particularly younger adults in this population, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. Little is known about the prevalence and predictors of antihypertensive medication adherence, a major determinant of hypertension control and cardiovascular disease, and differences between age groups in this fast-growing population.
The cross-sectional study included 1,043 community-dwelling Hispanic adults with hypertension living in 3 northern Manhattan neighborhoods from 2011 through 2012. Age-stratified analyses assessed the prevalence and predictors of high medication adherence (score of 8 on the Morisky Medication Adherence Scale [MMAS-8]) among younger (<60 y) and older (≥60 y) Hispanic adults.
Prevalence of high adherence was significantly lower in younger versus older adults (24.5% vs 34.0%, P = .001). In younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence, but poor self-rated general health was positively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and private insurance or Medicare versus Medicaid were positively associated with high adherence, whereas recent poor physical health and health-related activity limitations were negatively associated with high adherence.
Equitable achievement of national hypertension control goals will require attention to suboptimal antihypertensive medication adherence found in this study and other samples of US Hispanics, particularly in younger adults. Age differences in predictors of high adherence highlight the need to tailor efforts to the life stage of people with hypertension.
美国西班牙裔人群，尤其是该人群中的年轻成年人，与其他种族/族裔群体相比，高血压控制不佳的患病率更高。关于抗高血压药物依从性的患病率和预测因素（高血压控制和心血管疾病的主要决定因素）以及这个快速增长人群中不同年龄组之间的差异，我们所知甚少。
这项横断面研究纳入了2011年至2012年居住在曼哈顿北部3个社区的1043名患有高血压的西班牙裔成年居民。年龄分层分析评估了年轻（<60岁）和年长（≥60岁）西班牙裔成年人中高药物依从性（在Morisky药物依从性量表[MMAS - 8]上得分8分）的患病率和预测因素。
年轻成年人的高依从性患病率显著低于年长成年人（24.5%对34.0%，P = .001）。在年轻成年人中，大量饮酒、高血压病程较长以及近期身体健康状况较差与高依从性呈负相关，但自我评定的总体健康状况较差与高依从性呈正相关。在年长成年人中，年龄增长、教育水平较高、对高血压控制的高知晓率以及私人保险或医疗保险与医疗补助相比，与高依从性呈正相关，而近期身体健康状况较差和与健康相关的活动受限与高依从性呈负相关。
要公平地实现国家高血压控制目标，需要关注本研究以及美国西班牙裔其他样本中发现的抗高血压药物依从性欠佳的情况，尤其是在年轻成年人中。高依从性预测因素的年龄差异凸显了根据高血压患者的生命阶段调整干预措施的必要性。
