Medication adherence and stroke/TIA risk in treated hypertensives: results from the REGARDS study.

Academic Article

Abstract

  • BACKGROUND: The extent to which low medication adherence in hypertensive individuals contributes to disparities in stroke and transient ischemic attack (TIA) risk is poorly understood. METHODS: Investigators examined the relationship between self-reported medication adherence and blood pressure (BP) control (<140/90 mm Hg), Framingham Stroke Risk Score, and physician-adjudicated stroke/TIA incidence in treated hypertensive subjects (n = 15,071; 51% black; 57% in Stroke Belt) over 4.9 years in the national population-based REGARDS cohort study. RESULTS: Mean systolic BP varied from 130.8 ± 16.2 mm Hg in those reporting high adherence to 137.8 ± 19.5 mm Hg in those reporting low adherence (P for trend < .0001). In logistic regression models, each level of worsening medication adherence was associated with significant and increasing odds of inadequately controlled BP (≥140/90 mm Hg; score = 1, odds ratio [95% confidence interval], 1.20 [1.09-1.30]; score = 2, 1.27 [1.08-1.49]; score = 3 or 4, 2.21 [1.75-2.78]). In hazard models using systolic BP as a mediator, those reporting low medication adherence had 1.08 (1.04-1.14) times greater risk of stroke and 1.08 (1.03-1.12) times greater risk of stroke or TIA. CONCLUSION: Low medication adherence was associated with inadequate BP control and an increased risk of incident stroke or TIA.
  • Keywords

  • Medication adherence, blood pressure control, stroke, transient ischemic attack, African Continental Ancestry Group, Aged, Antihypertensive Agents, Cohort Studies, European Continental Ancestry Group, Female, Humans, Hypertension, Incidence, Ischemic Attack, Transient, Logistic Models, Male, Medication Adherence, Middle Aged, Odds Ratio, Risk Factors, Southeastern United States, Stroke
  • Digital Object Identifier (doi)

    Author List

  • Cummings DM; Letter AJ; Howard G; Howard VJ; Safford MM; Prince V; Muntner P
  • Start Page

  • 363
  • End Page

  • 369
  • Volume

  • 7
  • Issue

  • 5