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.