Int. J. Environ. Res. Public Health 2011, 8 2506 medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes. Keywords: medication cardiovascular disease use; minority; African-Americans; Jackson Heart Study; 1. Introduction In recent years, medical science has reported some degree of progress in the struggle against cardiovascular disease (CVD), but it remains a major health concern, accounting for approximately 1 million deaths in the United States each year [1]. Progress has been attributed to strategic active prevention of the various risk factors, improvements in healthcare, and the development and use of new therapies. Even though the potential of some medications to slow the progress of atherosclerosis and the development of CVD has received wide exposure, large numbers of individuals resist medication adherence and fail to take advantage of the potential benefits of a daily medical regimen [2]. Medication non-adherence reduces the effectiveness of therapies. Munger, Van Tassell, & LaFleur [3] have referred to non-adherence as an unrecognized risk factor and as a pervasive medical problem that negatively affects treatment outcomes. One third to one half of patients do not comply with prescribed treatment regimens [4-6]. Non-adherent patients have also exhibited higher glycosylated hemoglobin, systolic and diastolic blood pressure, and low-density lipoprotein cholesterol levels [7]. Non-adherence has been identified as a frequent cause of relapse among patients [8]. Immune suppression therapy non-adherence is the leading avoidable cause of renal transplant failure. Renal transplant patients particularly at risk may be those who have a history of non-adherence to medical advice [9]. Between one third and two thirds of all medication-related hospital admissions are attributed to non-adherence [10], costing the healthcare system an estimated $ 792 million to $1 billion annually [4,11]. In patients with hypertension, medication non-adherence is a significant, often unrecognized, risk factor that contributes to poor blood pressure control, which could later lead to the development of more serious disorders like heart failure, coronary heart disease, renal insufficiency, and stroke [3]. One study found that fewer than 50% of patients who were prescribed statin medications were adherent 12 months after initiating treatment, and other research has demonstrated that non-adherence to oral hypoglycemics and antihypertensive medications has been associated with higher HbA1c and BP levels, respectively [12,13]. The practice of non-adherence results in only 59% of people with hypertension regularly receiving effective treatment [14]. Hypertension increases the chances for stroke, end-stage renal disease, and heart failure, as well as contributes to the prevalence of insulin resistance, lipid abnormalities, changes in