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

Autor: Valerie Prince, George Howard, Paul Muntner, Virginia J. Howard, Abraham J. Letter, Monika M. Safford, Doyle M. Cummings
Rok vydání: 2013
Předmět:
Zdroj: Journal of the American Society of Hypertension. 7:363-369
ISSN: 1933-1711
DOI: 10.1016/j.jash.2013.05.002
Popis: The extent to which low medication adherence in hypertensive individuals contributes to disparities in stroke and transient ischemic attack (TIA) risk is poorly understood.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.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.Low medication adherence was associated with inadequate BP control and an increased risk of incident stroke or TIA.
Databáze: OpenAIRE