ArticleAmerican journal of hypertension2023
Adverse Childhood Experiences, Depression, Patient Activation, and Medication Adherence Among Patients With Uncontrolled Hypertension.
Article in American journal of hypertension, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Psychological determinants of medication adherence in patients with hypertension: a systematic review and meta‑analysis.Journal of behavioral medicine · 2026Pooled it
- The intersection between race/ethnicity and adverse childhood experiences and its association with depression.Social psychiatry and psychiatric epidemiology · 2026Article
- The Impact of Childhood Household Violence on HIV-Related Outcomes in People With HIV in the United States: The Role of Psychological Distress and Social Stressors.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- NF-κB/ICAM-1 signaling regulates vascular dysfunction in depressive hypertension rats.Scientific reports · 2025Article
- Impact of Adverse Childhood Experiences on Cardiovascular Health across the Lifespan.Current hypertension reports · 2025Review
- Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 revision).Journal of geriatric cardiology : JGC · 2025Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIdentifying potential pathways through which adverse childhood experiences (ACEs) impact health and health behavior remains important, given ACE survivors' increased risk for cardiovascular disease and poor cardiovascular health behaviors. This study examines whether modifiable variables-depression and patient activation-explain the relationship between ACEs and medication adherence.
methodsUsing baseline data from a pragmatic trial designed to decrease disparities in hypertension control, we conducted regression analyses to examine whether depression and patient activation mediated the association between ACEs and medication adherence. Data were collected between August 2017 and October 2019 (n = 1,818).
resultsParticipants were predominantly female (59.4%) and Black or African American (57%) with uncontrolled blood pressure (mean-152.3/85.5 mm Hg). Most participants reported experiencing at least 1 ACE (71%) and approximately 50% reported being adherent to their blood pressure medication. A significant indirect effect between ACEs and medication adherence was found for depression symptoms (Sobel's test z = -5.46, P < 0.001). Patient activation was not a mediator in these relationships.
conclusionsExperiencing more depression symptoms significantly accounted for the association between ACEs and medication adherence in a diverse sample of adults with uncontrolled blood pressure. Addressing depression symptoms, which may result from experiences with ACEs and other current stressors, could translate to better medication adherence and, potentially, better blood pressure control among this high-risk group. Given the serious lifetime health implications of ACEs, continued efforts are needed for primary prevention of childhood adversities.
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