Pehuenche social representations of arterial hypertension: the problem Of adherence to medication

Arterial hypertension is one of the principal risk factors of cardiovascular diseases among many different cultural groups in the country1. Objective: Describe Pehuenche social representations relating to adherence to antihypertensive medications, within the health belief system of the Pehuenche community in the municipality of Alto Bío Bío. Material and method: This is a qualitative investigation, based on phenomenology, with a non-probabilistic sample of consecutive cases taken from the Pehuenche population. Information was collected through semi-structured interviews. Structural semantics was used to analyze the results, which allowed pertinent description of the health belief structure. Results: Results indicate that the problem of adherence to medications in indigenous patients lies in the belief that these medications are only "soothing" ("calmantes") and don't cure the causes of disease. This is due to the fact that, from a cultural, magical and   religious viewpoint, the causes of disease are believed to be found on a physical, spiritual and religious level, and not in the clinical or individual context. Conclusion: The problem of adherence to antihypertensive medications, defined as the grade in which the patient's behavior towards taking medications coincides with the instructions provided by the doctor2, is found in the Pehuenche population. Because their traditions don't include hypertension as a valid and historically recognized disease, the treatment is seen as a luxury and is disengaged from the rites and traditions the keep their culture alive. Antihypertensive treatment is considered harmful to traditional Pehuenche institutions.