Urban dwellers take fewer prescriptions for hypertension medications and have fewer primary care providers than rural residents. Residents of the western states are less likely to take high blood pressure medications. The findings were presented at the American Heart Association‘s Hypertension Scientific Sessions in San Diego.
According to Samantha Schoenl, a fourth-year medical student at Medical College of Georgia in Augusta, traditionally, researchers thought that people living in rural areas tend to have lower adherence rates since they have less access to care and public transportation.
“In urban environments, you’d think having more transportation options would help, but that’s not what the data showed”
Samantha Schoenl, Medical College of Georgia in Augusta
Researchers at the Centers for Disease Control and Prevention analyzed data from more than 11,000 people in the 2020 National Health Interview Survey.
According to the researchers, nearly 76% of urban residents took their blood pressure medications as prescribed by their doctors, with adherence increasing as population density decreased. Nearly 82% of people living in large fringe urban areas and medium urban areas take their blood pressure medication. Non-metro areas with fewer than 10,000 people had 83% adherents.
There were also regional differences found by researchers. In the Northeast, 83% of people take their prescribed medications as prescribed. Over 81% of people in the South took their medications, while 79% of people in the Midwest did. Medication adherence was lowest in the West, at 77%.
A correlation was found between medication adherence and access to primary care, suggesting those with less access to health care were more likely to stop taking their medications. It was not the case that rural areas had less access to physicians than urban ones.
About 14% of the U.S. population lives in a rural area, but only one-tenth of primary care physicians practice there. Yet 97% of rural residents in this study reported having access to regular care if they needed it, compared to less than 95% of people in large urban areas.
Schoenl said access to care also can be affected by income, a variable the researchers didn’t factor in. Another issue could be that people in cities tend to move more than those who live in rural areas and might have less continuity of care, she said.
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