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Hypertension control, predictors for medication adherence and gender differences in older Chinese immigrants

Authors

  • Wen-Wen Li,

    1. Wen-Wen Li MS PhD RN Adjunct Assistant Professor Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, USA
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  • Margaret I. Wallhagen,

    1. Margaret I. Wallhagen PhD RN GNP Professor Department of Physiological Nursing Director John A. Hartford Center of Geriatric Nursing Excellence School of Nursing, University of California, San Francisco, California, USA
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  • Erika S. Froelicher

    1. Erika S. Froelicher MPH PhD RN Professor Department of Physiological Nursing, School of Nursing and Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA
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W.-W. Li:
e-mail: wenwenli@yahoo.com

Abstract

Title. Hypertension control, predictors for medication adherence and gender differences in older Chinese immigrants

Aim.  This paper is a report of a study to explore the relationship between demographic and cultural factors and antihypertensive medication adherence in older Chinese immigrants.

Background.  Hypertension is a well-known controllable risk factor for cardiovascular diseases worldwide, but only 20–80% of patients who take antihypertensive medications adhere adequately to their treatment regimen.

Methods.  A cross-sectional study was conducted between 2002 and 2003, with a convenience sample of 75 older men and 69 older women (n = 144, response rate 80%). Medication adherence was defined as ≥80% of the total score on the Morisky scale.

Findings.  Age (75·2 ± 5·7 vs. 75·9 ± 7·0 years, P = 0·51) and length of stay in the United States of America (12·7 ± 6·4 vs. 12·7 ± 6·6 years, P = 0·97) were similar for men and women. More men were married (85% vs. 46%, P < 0·01). A smaller proportion of men were poor (39% vs. 65%, P < 0·01), believed in religion (49% vs. 70%, P = 0·01), and could speak no English (32% vs. 57%, P < 0·01). Fewer men used Chinese herbs to treat hypertension (4% vs.13%). Hypertension control was low for men and women (53% and 48%, P = 0·51). Adherence in men and women was 69% and 75% (P = 0·42) respectively. For men, shorter length of stay in the United States of America was negatively associated with non-adherence (OR = 0·16; 95% CI: 0·05, 0·57). No association between length of stay and non-adherence was found for women.

Conclusion.  More research, including gender-specific studies, is needed to understand better how to develop an effective and culturally sensitive strategy to help older Chinese immigrants manage their hypertension.

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