Objective: To determine factors associated with failure to adhere to treatment for diagnosed hypertension among a representative sample of older Mexican adults living in the community.
Methods: A cross-sectional study of 2,029 individuals 65 years of age or older with diagnosed hypertension who participated in the Mexican Health and Aging Study, carried out during the summer of 2001. The survey collected information on several demographics (age, sex, schooling, whether living alone, and employment status, among others), any chronic illnesses, symptoms of depression, cognitive deterioration, body mass index, smoking, alcohol consumption, and difficulty performing basic and instrumental activities of daily living. Simple and multifactorial logistical regression analyses were used to evaluate the association among the study variables and self-reported untreated high blood pressure.
Results: Of the 2,029 participants, 437 (21.5%) reported not following any treatment whatsoever for controlling their hypertension; 1,584 (78.1%) affirmed they were complying with treatment; and 8 (0.4%) did not respond to this question. The multifactorial analysis adjusted for confounding variables (age, sex, symptoms of depression, and cognitive deterioration) showed that only a low number of years of schooling (adjusted odds ratio [OR] = 1.70; 95% confidence interval [95%CI]: 1.10-2.64; P = 0.02 for 1-6 years of schooling and adjusted OR = 3.32; 95%CI: 2.10-5.24; P < 0.01 for no schooling), alcohol consumption (adjusted OR = 1.52; 95%CI: 1.14-2.03; P = 0.01), and urinary incontinence (adjusted OR = 1.61; 95%CI: 1.15-2.26;P < 0.01) were independently associated with hypertension.
Conclusions: Hypertension is a common and important issue among older adults in Mexico. To obtain better medication compliance, doctors prescribing or modifying hypertension treatment should taken into account whether or not the patient suffers from urinary incontinence, consumes alcohol, and/or has a low level of schooling.