Patient perspectives on living with hypertension: Social media listening analysis across predominantly high-income countries

BackgroundChronic conditions such as hypertension can significantly disrupt daily life and emotional well-being. The interaction between patients perceptions, adherence to antihypertensive medication and quality of life (QoL) remains underexplored outside structured clinical settings. ObjectivesTo capture unprompted patient perspectives and assess whether hypertension affects QoL and to investigate if patient reported experiences are associated with self-reported antihypertensive medication adherence. MethodsSocial media listening (SML) study analyzing 86,368 anonymized posts from individuals with hypertension in 12 countries, collected between January 2022 and May 2024. Posts from 11 countries (n=81,368) were analyzed using artificial intelligence-enabled natural language processing. Posts from China (n=5,000) were analyzed separately using a harmonized framework. Quantitative and qualitative methods assessed variations by country, age, and gender, and associations between emotional expression and antihypertensive medication adherence. ResultsAcross the 11-country core sample, 45% of posts mentioned at least one QoL impact, most commonly worry/anxiety (11%). Impacts varied across countries. Among 8,096 posts with age identified, individuals <40 years reported emotional balance impacts in 28% of posts versus 22% among those aged 40+. Work/Education impacts were mentioned in 17% of posts by those <40 years vs 12% in 40+. Among 7968 posts explicitly referencing adherence, expressed worry was associated with stricter adherence (62% association score), as were structured routines (79% score), home monitoring (77%), dietary changes (77%), and exercise (71%). In contrast, sadness/depression was associated with inconsistent adherence (71%), as were forgetfulness (79%), side effects (73%), and cost/insurance concerns (65%). ConclusionsThese results emphasize the importance of the psychological and emotional impact of hypertension, including on adherence to medication regimens, reinforcing the value of a holistic approach to patient care. Plain language summaryMany people have high blood pressure, which increases the risk for stroke and other harmful events. Although there is much medical research on high blood pressure, little is known about the experiences of those people who live with the condition. This study aimed to scope out how people react emotionally and how their high blood pressure affects their daily lives. To do this, we analyzed social media posts from the United States, Canada, Brazil, the United Kingdom, Germany, France, Italy, Spain, Japan, South Korea, China, and Australia. In all countries, patients were affected emotionally by their high blood pressure. People often worried, particularly when they received their diagnosis. High blood pressure also negatively affected everyday life and work/education. This was often due to frequent medical appointments with lengthy wait times and difficulty accessing specialists. Taking medications regularly and sticking to diet and exercise programs was more difficult for individuals who reported being sad or depressed, or who suffered from side effects of their medications. The findings show that efficient management of high blood pressure has to take into account the emotional reactions of those who are affected, and provide support in several areas beyond the prescription of medication.