ArticlePloS one2015
Adherence to Antihypertensive Therapy and Elevated Blood Pressure: Should We Consider the Use of Multiple Medications?
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Adherence to antihypertensives in the United States: A comparative meta-analysis of 23 million patients.Journal of clinical hypertension (Greenwich, Conn.) · 2024Pooled it
- Sex differences in the adherence of antihypertensive drugs: a systematic review with meta-analyses.BMJ open · 2020Pooled it
- Factors associated with antihypertensive medication non-adherence: a systematic review.Journal of human hypertension · 2017Pooled it
- Effect of FIXed-dose combination of ARb and statin on adherence and risk factor control: The randomized FIXAR study.Cardiology journal · 2022Trial
- Trial
- Family member-based supervision of patients with hypertension: a cluster randomized trial in rural China.Journal of human hypertension · 2017Trial
- Effectiveness of a Knowledge Level of Hypertension on Blood Pressure Control, Treatment Adherence, and Physical Activity of Hypertensive Individuals.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Predictors of Non-Adherence to Medications in Hypertensive Patients.Iranian journal of public health · 2023Article
- A comparison of methods for the measurement of adherence to antihypertensive multidrug therapy and the clinical consequences: a retrospective cohort study using the Korean nationwide claims database.Epidemiology and health · 2023Article
- Towards better reporting of the proportion of days covered method in cardiovascular medication adherence: A scoping review and new tool TEN-SPIDERS.British journal of clinical pharmacology · 2022Article
- Medication adherence among persons with coronary heart disease and associations with blood pressure and low-density-lipoprotein-cholesterol.European journal of clinical pharmacology · 2022Article
- Adherence to treatment for hypothyroidism in pregnancy and relationship with thyrotropin control: a retrospective observational cohort study.BMC pregnancy and childbirth · 2022Observational
- Predictors of poor medication adherence of older people with hypertension.Nursing open · 2022Article
- Medication Adherence Among Hypertensive Patients Attending Different Primary Health Centers in Abha, Saudi Arabia: A Cross-Sectional Study.Patient preference and adherence · 2022Article
- Determinants of Adherence to Antihypertensives Among Elderly: A Multifactorial Concern.Patient preference and adherence · 2022Article
- The long-term impact of expansion sphincter pharyngoplasty treatment on blood pressure control and health-related quality of life in patients with obstructive sleep apnea and hypertension.Sleep & breathing = Schlaf & Atmung · 2021Article
- Projecting the long-term benefits of single pill combination therapy for patients with hypertension in five countries.International journal of cardiology. Cardiovascular risk and prevention · 2021Article
- Treatment and adherence to antihypertensive therapy in France: the roles of socioeconomic factors and primary care medicine in the ESTEBAN survey.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Comparing the Sensitivities of Measures of Adherence to Antihypertensive Drugs Using Korean National Health Insurance Claims Data.Patient preference and adherence · 2021Article
- Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough a majority of patients with hypertension require a multidrug therapy, this is rarely considered when measuring adherence from refill data. Moreover, investigating the association between refill non-adherence to antihypertensive therapy (AHT) and elevated blood pressure (BP) has been advocated.
objectiveIdentify factors associated with non-adherence to AHT, considering the multidrug therapy, and investigate the association between non-adherence to AHT and elevated BP.
methodsA retrospective cohort study including patients with hypertension, identified from a random sample of 5025 Swedish adults. Two measures of adherence were estimated by the proportion of days covered method (PDC≥80%): (1) Adherence to any antihypertensive medication and, (2) adherence to the full AHT regimen. Multiple logistic regressions were performed to investigate the association between sociodemographic factors (age, sex, education, income), clinical factors (user profile, number of antihypertensive medications, healthcare use, cardiovascular comorbidities) and non-adherence. Moreover, the association between non-adherence (long-term and a month prior to BP measurement) and elevated BP was investigated.
resultsNon-adherence to any antihypertensive medication was higher among persons < 65 years (Odds Ratio, OR 2.75 [95% CI, 1.18-6.43]) and with the lowest income (OR 2.05 [95% CI, 1.01-4.16]). Non-adherence to the full AHT regimen was higher among new users (OR 2.04 [95% CI, 1.32-3.15]), persons using specialized healthcare (OR 1.63, [95% CI, 1.14-2.32]), and having multiple antihypertensive medications (OR 1.85 [95% CI, 1.25-2.75] and OR 5.22 [95% CI, 3.48-7.83], for 2 and ≥3 antihypertensive medications, respectively). Non-adherence to any antihypertensive medication a month prior to healthcare visit was associated with elevated BP.
conclusionSociodemographic factors were associated with non-adherence to any antihypertensive medication while clinical factors with non-adherence to the full AHT regimen. These differing findings support considering the use of multiple antihypertensive medications when measuring refill adherence. Monitoring patients' refill adherence prior to healthcare visit may facilitate interpreting elevated BP.
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