• Elizabeth A Rogers, Hani Abi, Mark Linzer, and David T Eton.
• From the Department of Medicine, University of Minnesota Medical School, Minneapolis, MN (EAR, ML); Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN (EAR, HA); Department of Medicine, Hennepin Healthcare, Minneapolis, MN (ML); Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN (DTE). earogers@umn.edu.
• J Am Board Fam Med. 2021 Nov 1; 34 (6): 1243-1245.

IntroductionNew hypertension guidelines in the United States may require more people to take multiple medications or implement lifestyle changes. Increased treatment burden may be an unintended consequence and lead to worse health outcomes. Our study examined whether treatment burden is associated with factors related to self-management in those with hypertension.MethodsWe conducted a cross-sectional mailed survey of patients from 2 medical centers in Minnesota. Participants with 2 or more medical conditions completed the Patient Experience with Treatment and Self-management (PETS), a validated treatment burden questionnaire, as well as measures of confidence in self-management ability, health literacy, health care-related financial difficulties, and perception of provider interpersonal skills. We used partial correlation analyses, controlling for age, sex, race, and education, to test relationships among study variables.ResultsOf 254 respondents who had a diagnosis of hypertension, 54% were female, 74% were non-Hispanic White, and the mean age was 67 years. People with hypertension who reported having lower confidence in self-management ability, lower health literacy, more financial difficulties, and health care providers with poorer interpersonal skills reported higher treatment burden scores (PETS scales correlation magnitude range 0.09 to 0.62, P < .05 on all but 4). The strongest associations were observed for medical information and physical/mental exhaustion with self-management (correlation magnitudes from 0.25 to 0.54, P < .01).DiscussionHypertension treatment guideline stringent blood pressure criteria may lead to more interventions-medical or lifestyle-creating strains on populations already challenged by abstract disease self-management and at risk of experiencing disparities in cardiovascular health outcomes.© Copyright 2021 by the American Board of Family Medicine.

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