Pilot--Depression &Treatment Adherence in Hypertensives

Mount Sinai School Of Medicine Of Nyu, New York NY

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Abstract

Hypertension is a prevalent disorder. Treatment for hypertension usually requires a patient to take daily medications, reduce sodium intake and lose weight, adhere to routine follow-up visits, and undergo routine monitoring tests. Adherence to such regimens requires a great degree of patient motivation and perseverance, convictions that often require strong feelings of self-efficacy. Hypertensive patients who are also depressed may be less likely to summon the necessary self-discipline to follow such a complex health routine. Depression is also a prevalent disorder; approximately 9.5% of U.S. adults ages >=18 suffer from a depressive disorder in any given year. The relatively high prevalence of these 2 conditions suggest that it is likely that both hypertension and depression will occur concomitantly. Current research is lacking on the extent to which depression complicates hypertension and adherence to anti-hypertensive treatment regimens. Specific Aims: 1) To describe the prevalence of depression among controlled and uncontrolled hypertensive minority patients; 2) To describe the prevalence of treatment adherence among depressed and nondepressed hypertensive patients; 3) To explore associations between depression, treatment adherence, and blood pressure control; 4) To assess the feasibility of recruiting minority hypertensive patients to undergo screening for depression. We will take advantage of an ongoing AHRQ-EXCEED-funded randomized trial among minority patients with uncontrolled hypertension and utilize the recruitment procedures and tools to identify minority patients with diagnosed and treated hypertension. We will assess patients for depression, anti-hypertensive treatment adherence and perceived self-efficacy. We will survey 30 controlled and 30 uncontrolled hypertensive minority patients recruited from the waiting rooms of clinics in East and Central Harlem. This pilot study is an exploration of the relationship of depression, attitudes toward treatment of depression, hypertension treatment adherence, self-efficacy and blood pressure control.