Cultural Factors Associated With Antihypertensive Medication Adherence in Chinese Immigrants

BACKGROUND: Little is known about hypertension control and cultural factors related to medication adherence in Chinese immigrants. OBJECTIVE: : The purpose of this study was to characterize Chinese immigrants with hypertension and to examine what cultural factors are associated with medication adherence. METHODS: A cross-sectional design was used. Data were gathered from a convenience sample of 200 subjects recruited in an Asian outpatient clinic in the San Francisco Bay Area using self-report questionnaires and blood pressure measurements. Participants were Chinese immigrants 18 years old and older, taking antihypertensive medications, and able to speak Mandarin. RESULTS: The mean age was 71 (+/-10) years. Half were men (50%). Most were married (70%), and reported an annual family income of <20,000 dollars (71%) and an average length of stay in the United States of 13 (+/-7) years. Medication adherence was reported by 75%, although only 51% had controlled hypertension. Four of 8 cultural factors were statistically significant predictors for medication nonadherence: lower perceived susceptibility OR = 3.77 (95% CI 1.19, 12.01); higher perceived benefit of Chinese herbs OR = 2.21 (95% CI 1.02, 4.81); lower perceived benefit of Western medications for hypertension OR = 2.78 (95% CI 1.13, 6.84); and longer length of stay in the United States OR = 2.48 (95% CI 1.12, 5.50). CONCLUSIONS: Four cultural factors were identified as significant predictors of medication nonadherence in this sample. These findings can guide culturally appropriate nursing interventions for hypertension management in Chinese immigrants.