ArticlePharmacotherapy2017
Relationships between Medication Adherence and Cardiovascular Disease Risk Factor Control in Elderly Patients with Diabetes.
Article in Pharmacotherapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 15 citations in OpenAlex.
- Knowledge of cardiovascular diseases among patients with diabetes mellitus in the Kingdom of Saudi Arabia: A cross-sectional study.Medicine · 2026Article
- Determinants of medication adherence in patients with diabetes, hypertension, and hyperlipidemia.Hormones (Athens, Greece) · 2025Article
- Group-based trajectory modeling to identify longitudinal patterns and predictors of adherence among older adults on concomitant triple therapy (oral antidiabetic, renin-angiotensin-system antagonists, statins).Journal of managed care & specialty pharmacy · 2025Article
- Evaluating Adherence to Concomitant Diabetes, Hypertension, and Hyperlipidemia Treatments and Cardiovascular Outcomes Among Elderly Patients Using Marginal Structural Modeling.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2022Article
- The Impact of Treatment Adherence for Patients With Diabetes and Hypertension on Cardiovascular Disease Risk: Protocol for a Retrospective Cohort Study, 2008-2018.JMIR research protocols · 2019Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe Centers for Medicare and Medicaid Services (CMS) Medicare Star program provides incentives to health plans when their patients with diabetes meet adherence targets to angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEIs/ARBs) and statins. While a link between adherence and cardiovascular risk factor control is established, most studies included young patients with few comorbidities. Whether the Star adherence target is associated with reduced blood pressure or low-density lipoprotein cholesterol (LDL-C) in complex older patients is not well understood.
objectivesDetermine correlates of adherence and examine the effect of meeting Star adherence targets on blood pressure and LDL-C in the Medicare-aged diabetes population. DESIGN AND SUBJECTS: Retrospective cohort study of 129,040 patients with diabetes aged 65 or older. MEASURES: Adherence estimated using proportion of days covered target ≥ 0.8; blood pressure < 140/90 mg Hg; LDL-C < 100 mg/dl. Modified Poisson regression used to assess relationships.
resultsAdherence differed little across elderly age groups. Compared to no comorbidity, high comorbidity (≥ 4) was associated with lower ACEI/ARB (risk ratio [RR] 0.88 [95% confidence interval (CI) 0.87-0.89]) or statin (RR 0.91 [0.90-0.92]) adherence. ACEI/ARB adherence was not associated with blood pressure < 140/90 mm Hg in patients ≥ 85 years (RR 1.01 [0.96-1.07]) or with multiple comorbidities (e.g., 3: RR 1.04 [0.99-1.08]). Statin adherence and LDL-C < 100 mg/dl were associated in all elderly age groups (e.g., ≥ 85: RR 1.13 [1.09-1.16]) and comorbidity levels (e.g., ≥ 4: RR 1.13 [1.12-1.15]).
conclusionsAdherence to ACEI/ARB is not linked with reduced blood pressure in patients with diabetes who are at least 85 years or with multiple comorbidities.
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