ArticleJournal of the American Heart Association2019
Combined Effect of Income and Medication Adherence on Mortality in Newly Treated Hypertension: Nationwide Study of 16 Million Person-Years.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 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.
The trial behind it
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
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- 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
- Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27 Million Patients.Journal of the American Heart Association · 2022Pooled it
- Factors associated with medication adherence trajectory among patients treated with oral anticancer drugs: a multicentre cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Influence of Sex on Therapeutic Adherence in Cardiovascular Diseases: A Scoping Review.Journal of clinical medicine · 2025Review
- Exploring the impact of the Index of Multiple Deprivation on percutaneous coronary intervention outcomes: Insights from the British Cardiovascular Intervention Society database.Global cardiology science & practice · 2025Article
- Adherence to Antibiotic Prescriptions Among Dental Patients in Saudi Arabia: A Cross-Sectional Study.Cureus · 2025Article
- Article
- Explainable SHAP-XGBoost models for identifying important social factors associated with the atherosclerotic cardiovascular disease risk score using the LASSO feature selection technique.Epidemiology and health · 2025Article
- Clinical Implementation of the Hill-Bone Compliance to High Blood Pressure Therapy Scale: Antihypertensive Adherence Assessment in a Romanian Cardiology Outpatient Center.Patient preference and adherence · 2025Article
- Factors associated with medication adherence among young adults with hypertension.Clinical hypertension · 2025Article
- Machine learning applications to classify and monitor medication adherence in patients with type 2 diabetes in Ethiopia.Frontiers in endocrinology · 2025Article
- Sex-based disparities with cost-related medication adherence issues in patients with hypertension, ischemic heart disease, and heart failure.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Effects of pain, hospitalization, and medication on depressive symptom in Syrian patients with chronic diseases.Scientific reports · 2024Article
- Analysis of Medication Adherence Status and Influencing Factors in Adolescents with Major Depressive Episodes.Actas espanolas de psiquiatria · 2024Article
- Secondary School Athletic Trainers' Perceptions of the Influence of Social Determinants of Health and Socioeconomic Status on Clinical Management Decisions.Journal of athletic training · 2024Article
- Myocardial infarction care in low and high socioeconomic environments: claims data analysis.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024Article
- An Analysis of Medication Adherence in a Large Outpatient Population During the COVID-19 Pandemic Using a Novel Value-Based Pharmacy System.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Article
- Antihypertensive medication nonadherence and target organ damage in children with chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2024Article
- Impact of dementia and drug compliance on patients with acute myocardial infarction.Clinical cardiology · 2023Article
- Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis.BMC public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Low socioeconomic status and poor medication adherence are known to be associated with increased morbidity and mortality among patients with hypertension, but their combined effects have not been studied. We therefore evaluated the joint association of household income and medication adherence with death and cardiovascular disease in patients newly treated for hypertension. Methods and Results This was a nationwide cohort study using the Korean National Health Insurance database. We included 1 651 564 individuals, aged 30 to 80 years, with newly treated hypertension and no prior cardiovascular disease and followed them for 10 years. Main exposures were household income in quintiles and adherence to antihypertensive medication, estimated by medication possession ratio: good (≥0.8), moderate (0.5 to <0.8), or poor (<0.5). The primary outcomes were all-cause and cardiovascular deaths. Higher mortality risk was observed in patients with low income (adjusted hazard ratio=1.50, 99% CI=1.46-1.53; lowest versus highest quintile) and poor medication adherence (adjusted hazard ratio=1.66, 99% CI=1.63-1.68; poor versus good adherence). When compared with the highest-income and good-adherence group, adjusted hazard ratio (99% CI) of death was 1.56 (1.52-1.61) for highest-income poor-adherers, 1.46 (1.41-1.51) for lowest-income good-adherers, and 2.46 (2.38-2.54) for lowest-income poor-adherers (P for interaction <0.001). Conclusions Low socioeconomic status and poor adherence to antihypertensive medication are associated with increased mortality and cardiovascular disease risks, but patients with low income are subject to larger excess risks by nonadherence. This highlights the potential importance of promoting medication adherence for risk reduction, especially in low-income patients with hypertension.
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