Associations between home remedy use and a validated self-reported adherence measure in an urban African-American population with poorly controlled hypertension

Objective: To determine associations between home remedy use and self-reported adherence among urban African Americans with poorty controlled hypertension. Methods: A cross-sectional structured interview of African Americans admitted to medical units for uncontrolled hypertension at an urban academic hospital from 1999-2004. Logistic regression was used to test associations between home remedy use and self-reported adherence. Results: One-hundred-eighty-three of 272 participants completed the study (67%); 39 (21%) reported using home remedies for hypertension. In a multivariate model, home remedy use was independently associated with greater medication adherence (OR for nonactherence=0.32, 95% CI: 0.14-0.75; p<0.01) and dietary adherence (OR for changing diet=3.28, 95% CI: 1.10-9.81; p=0.03), but not lifestyle or appointment adherence. These associations remained strong while controlling for age; sex; employment status; and key covariates, including greater medication side effects (ORM.31; 95% CI: 1.64-11.3; p<0.01), greater difficulty paying for medications (OR=2.94 95% CI: 1.25-6.92; p=0.01) and longer duration of diagnosis (OR for log years=1.53; 95% CI: 1.02-2.33: p=0.045). Conclusion: Home remedy use may be a marker of positive self-care for some hypertensive African Americans and not a promoter of nonadherence.