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Social Adversity Experience and Blood Pressure Control Following Antihypertensive Medication Use in a Community Sample of Older Adults

International Journal of Behavioral Medicine volume 21, pages 456–463 (2014)Cite this article

Abstract

Background

Psychosocial stress is a risk factor for hypertension and has been shown to affect response to treatment for psychiatric illnesses.

Purpose

We investigate the relationship between a history of social adversity experience and blood pressure control following antihypertensive medication use.

Methods

A total of 1,186 participants selected from the European Prospective Investigation into Cancer-Norfolk study (531 men and 655 women, aged 42 to 80 years) had attended two health checks at which blood pressure measurements were taken; were taking antihypertensive medication at the second, but not the first health check; and had completed a questionnaire assessment of their social and psychological circumstances which included details of traumatic experiences in childhood and of adverse life events, long-term difficulties, and perceived stress in adulthood.

Results

Experience of recent loss events in adulthood was associated with a smaller reduction in systolic blood pressure after starting hypertension treatment (β = 1.78, 95 % confidence interval 0.15–3.40, per life event), independently of age, sex, preexisting health conditions, cigarette smoking history, alcohol consumption, physical activity, and obesity.

Conclusion

Results from this study suggest that stress caused by recent losses may be associated with reduced effectiveness of treatment for hypertension. Subject to replication, these findings may help determine the specific physiological mechanisms by which medication treatment effectiveness is affected by stress.

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Acknowledgments

We thank the participants and general practitioners who took part in the EPIC-Norfolk study and the staff associated with the research program. EPIC-Norfolk is supported by program grants from the Medical Research Council UK (G9502233, G0300128) and Cancer Research UK (C865/A2883).

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Authors and Affiliations

  1. International Health Research Group, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK

    Nicholas WJ Wainwright

  2. Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Miami, FL, USA

    Sheldon Levy & Jose Pico

  3. Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, UK

    Robert N Luben & Paul G Surtees

  4. Clinical Gerontology Unit, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, Cambridge, UK

    Kay-Tee Khaw

Authors
  1. Nicholas WJ Wainwright
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  2. Sheldon Levy
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  3. Jose Pico
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  4. Robert N Luben
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  5. Paul G Surtees
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Correspondence to Nicholas WJ Wainwright.

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Wainwright, N.W., Levy, S., Pico, J. et al. Social Adversity Experience and Blood Pressure Control Following Antihypertensive Medication Use in a Community Sample of Older Adults. Int.J. Behav. Med. 21, 456–463 (2014). https://doi.org/10.1007/s12529-013-9319-9

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  • DOI: https://doi.org/10.1007/s12529-013-9319-9

Keywords

  • Blood pressure control
  • Hypertension treatment
  • Life events
  • Social adversity