Observational studyInternational journal of cardiology2013
Drug adherence and the incidence of coronary heart disease- and stroke-specific mortality among 218,047 patients newly prescribed an antihypertensive medication: a five-year cohort study.
Observational study in International journal of cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- A systematic review of medication adherence and mortality in chronic disease: Implications for clinical guidelines and policy.British journal of clinical pharmacology · 2026Pooled it
- Comparative analysis of burden of topmost disorders requiring rehabilitation services: a systematic review and meta-analysis.Journal of translational medicine · 2025Pooled it
- The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies.BMC cardiovascular disorders · 2025Pooled it
- Adherence to Antihypertensive Medications and Stroke Risk: A Dose-Response Meta-Analysis.Journal of the American Heart Association · 2017Pooled it
- Trial
- Is clopidogrel better than aspirin following breakthrough strokes while on aspirin? A retrospective cohort study.BMJ open · 2014Trial
- Hypertension Care Quality and Incidence of Complications Among Hypertensive Patients With Disabilities in Korea: An Analysis of a Cohort Study Using National Health Insurance Data.Journal of Korean medical science · 2026Article
- Article
- Beyond prescriptions: chronic medication adherence predicts mortality risk in a large-scale cohort study.Frontiers in pharmacology · 2025Article
- Association between post-stroke smoking and stroke recurrence in first-ever ischemic stroke survivors: based on a 10-year prospective cohort.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy.ClinicoEconomics and outcomes research : CEOR · 2022Article
- Secondary prevention medication persistence and prognosis of acute ischaemic stroke or transient ischaemic attack.Stroke and vascular neurology · 2021Article
- Effectiveness of low-cost reminder package combined with case-based health education to improve hypertensive patients' medication adherence: a clustered randomized controlled trial.Patient preference and adherence · 2019Article
- Improving Medication Adherence in Coronary Heart Disease.Current cardiology reports · 2017Review
- Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population-Based Cohort Study.Journal of the American Heart Association · 2017Article
- Association between medication adherence and clinical outcomes in patients with chronic kidney disease: a prospective cohort study.Clinical and experimental nephrology · 2017Article
- Impact of Appointment-Based Medication Synchronization on Existing Users of Chronic Medications.Journal of managed care & specialty pharmacy · 2015Article
- The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings.Singapore medical journal · 2015Article
- The 2014 hypertension guidelines: implications for patients and practitioners in Asia.Heart Asia · 2015Article
- A qualitative study on hypertensive care behavior in primary health care settings in Malaysia.Patient preference and adherence · 2014Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized trials have shown that optimal adherence to antihypertensive agents could protect against cardiovascular diseases, but whether adherence reduces cardiovascular deaths in community settings has not been explored so fully. This study evaluates the association between antihypertensive adherence and cardiovascular (coronary heart disease and stroke) mortality in the primary care settings.
methodsFrom a territory-wide database in Hong Kong, we included all patients who were prescribed their first-ever antihypertensive agents in the years between 2001 and 2005 from the public healthcare sector. All patients were followed up for five years, and assigned as having poor (Proportion of Days Covered [PDC]<40%), intermediate (40-79%), and high (≥ 80%) adherence to antihypertensive agents. The association between antihypertensive adherence and cardiovascular mortality was evaluated by using the Cox proportional hazard models.
resultsFrom a total of 218,047 eligible patients, 3825 patients (1.75%) died of cardiovascular disease within five years after having received their first-ever antihypertensive agents. The proportions of patients having poor, intermediate, and high medication adherence were 32.9%, 12.1%, and 55.0%, respectively. Higher adherence levels at PDC 40%-79% (HR=0.46, 95% C.I. 0.41-0.52, p<0.001) and ≥ 80% (HR=0.91, 95% C.I. 0.85-0.98, p=0.012) were significantly less likely to be associated with mortality than the poor adherence (PDC0.040) group.
conclusionsBetter antihypertensive adherence was associated with lower cardiovascular mortality. This highlights the need to promote adherence through strategies which have been proved to be effective in clinical settings.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.