PSYCHOSOCIAL FACTORS INFLUENCING HYPERTENSION MANAGEMENT AND MEDICATION ADHERENCE

Abstract

Background: Hypertension is a chronic condition with significant global health burdens. While pharmacologic therapy is essential, psychosocial factors such as stress, anxiety, and social support considerably affect medication adherence and blood pressure control, particularly in low- and middle-income settings.

Objective: To evaluate the impact of perceived stress, anxiety, and social support on medication adherence and blood pressure control among hypertensive patients attending tertiary care hospitals in Punjab, Pakistan.

Methods: A cross-sectional study was conducted over eight months (March to October 2024) involving 355 adult hypertensive patients. Validated instruments were used: Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder Scale (GAD-7), Multidimensional Scale of Perceived Social Support (MSPSS), and the Morisky Medication Adherence Scale (MMAS-8). Blood pressure readings were obtained following standardized procedures. Descriptive statistics, Pearson correlations, and multiple linear regression analyses were used to evaluate associations between psychosocial variables, adherence levels, and blood pressure control. Ethical approval was obtained, and informed consent was secured from all participants.

Results: The mean age was 52.3 ± 10.8 years; 47% had hypertension for more than 5 years. The average PSS-10, GAD-7, and MSPSS scores were 18.5 ± 6.2, 9.1 ± 5.4, and 52.6 ± 13.8, respectively. Only 28.7% of patients demonstrated high adherence, while 42.3% had uncontrolled blood pressure. Higher stress and anxiety scores were significantly associated with lower adherence (p < 0.01), whereas greater perceived social support positively correlated with better adherence and BP control.

Conclusion: Psychosocial factors significantly influence hypertension management. Integrating mental health screening and social support mechanisms into hypertension care protocols may enhance adherence and control outcomes.