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International Journal of Hypertension
Volume 2013, Article ID 358562, 8 pages
Research Article

Effects of Emotional Response on Adherence to Antihypertensive Medication and Blood Pressure Improvement

1Denver Health Medical Center, Denver, CO, USA
2Department of Family Medicine, University of Colorado and Level One Physicians, Denver Health, MC 1914, 301 West 6th Avenue, Denver, CO 80204, USA
3Driscoll Consulting, Boulder, CO 80303, USA

Received 17 September 2012; Revised 27 November 2012; Accepted 11 December 2012

Academic Editor: Claudio Borghi

Copyright © 2013 Robert D. Keeley and Margaret Driscoll. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Developing interventions to improve medication adherence may depend upon discovery of novel behavioral risk factors for nonadherence. Objective. Explore the effects of emotional response (ER) on adherence to antihypertensive medication and on systolic blood pressure (SBP) improvement. Design. We studied 101 adults with diabetes and hypertension. The primary outcome, 90-day “percentage of days covered” adherence score, was determined from pharmacy refill records. The secondary outcome was change in SBP over 90 days. ER was classified as positive, negative, or neutral. Results. Average adherence was 71.6% (SD 31.4%), and negative and positive ER were endorsed by 25% and 9% of subjects, respectively. Gender moderated the effect of positive or negative versus neutral ER on adherence (interaction ); regardless of gender, negative and positive ER were associated with similarly high and low adherence, respectively, but males endorsing neutral ER had significantly higher adherence than their female counterparts (85.6% versus 57.1%, F value = 15.3, ). Adherence mediated ER's effect on SBP improvement: among participants with negative, but not positive or neutral, ER, increasing adherence and SBP improvement were correlated (Spearman’s , ). Conclusions. Negative, but not positive or neutral, ER predicted better medication adherence and a correlation between medication adherence and improvement in SBP.