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Dec 10, 2017

Medication Adherence is Critical for Preventing Heart Disease in African-Americans

Strategies for improving health include cardiac rehab and better education and counseling about treatment.

Improving medication adherence will help eliminate health disparities in the United States, based on a recent review of high blood pressure and heart disease in African-Americans.

Published in The Journal of Clinical Hypertension, this review looked at how medication adherence impacts heart health among blacks, who are two to three times as likely to die of heart disease and stroke as whites. They’re also at greater risk for high blood pressure—a leading cause of heart disease—yet less likely to have their condition under control. Since poor medication adherence contributes to this health disparity, experts continue to explore the issue in hopes of identifying a 

After reviewing the latest evidence, researchers identified two key barriers to treatment. The first was poor communication between patients and their providers. Studies suggest that doctors are not providing sufficient education for black patients, particularly about treatment for chronic conditions like high blood pressure. For example, many black patients with hypertension are unaware that high blood pressure requires ongoing treatment, even when it causes no symptoms.

The second barrier experts identified was socioeconomic status, which includes factors like income and education. Studies suggest that patients with higher income and education are more likely to take medications than those with lower socioeconomic status. Factors like insurance, employment, living conditions, access to transportation and even social support also had a significant impact on medication adherence.

To address these issues, authors suggest a number of strategies to improve medication adherence among blacks.

First, experts highlight the importance of cardiac rehab, which is available to patients with heart disease and other conditions. Cardiac rehab is designed to help patients learn about their condition, understand the importance of treatment and adopt a heart-healthy lifestyle. While cardiac rehab is largely underutilized, it would be particularly beneficial in black patients, who face the greatest risk for heart disease.

Second, experts encourage the use of modern technology like websites, smartphone apps, and text messages to improve medication adherence. These resources are relatively low-cost and can provide daily support to help patients take their medication as prescribed. Authors also note the potential of digital pillboxes, which use light and sound to remind patients to take their medication. Studies suggest that digital pill bottles may improve medication adherence by 27%.

And lastly, authors recommend approaches for better education and communication between patients, providers and even pharmacists. As authors explain, patients need to understand why they’re taking the medication they’re prescribed and how it will benefit their health in order to stick with therapy over time. It’s also important that patients have the opportunity to discuss factors like personal preferences or insurance, so they can work with providers to overcome potential challenges for their treatment plan.

Together, experts believe these strategies will improve medication adherence and help close the gap in health disparities for African-Americans.

Questions for You to Consider

  • What are health disparities?
  • Health disparities refer to differences in health outcomes or burdens of disease between groups of people. Health disparities can exist between different populations of race, sex, income, or even geographic location. In health care, the goal is to eliminate these differences so all individuals have the same ability to achieve good health.
  • What is hypertension?
  • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases risk for heart attack and stroke.

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