Black women have the highest rates of hypertension in the United States. This may be connected to the stress Black Americans face, which in turn may lead to lower treatment adherence and blood pressure control. Mr. Augustine Kang, a doctoral candidate at the Brown School of Public Health, and colleagues analyzed data among at-risk or hypertensive Black women to assess stress and adherence to medication and lifestyle management strategies, and found that non-adherence to lifestyle management strategies in particular was associated with higher levels of stress.
The study investigated the relationship between stress, adherence and blood pressure control among a socioeconomically and ethnically diverse group of Black women. The study measured self-reported stress, adherence to both medication and lifestyle management strategies (e.g. diet and exercise) and demographics. To measure medication adherence, participants reported the number of days they took their medication in the past four weeks as instructed. To measure adherence to lifestyle management, participants reported the frequency to which they followed their physician’s lifestyle management recommendations over the past four weeks. Clinical variables were also measured, and these include BMI, waist circumference, and blood pressure readings.
Mr. Kang and his colleagues found that stress was associated with being younger and also being a single parent. Stress was also associated with higher levels of systolic blood pressure.
84 percent of Black women did not meet the criteria for medication adherence while 59 percent did not meet the criteria for lifestyle management adherence. There were no significant differences in stress levels between participants who were adherent to their medications and those who were not adherent. However, the study found that stress levels were higher among participants who were not adherent to lifestyle management strategies compared to those who were adherent.
This study demonstrated a relationship between adherence to lifestyle management strategies, stress and higher levels of blood pressure. Future studies may expand on this relationship to investigate why stress is related to lifestyle management strategies and potentially lead to the design of effective interventions to mitigate such an effect.