Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study

Mark J. Butler, Rikki M. Tanner, Paul Muntner, Daichi Shimbo, Adam P. Bress, Amanda J. Shallcross, Mario Sims, Olugbenga Ogedegbe, Tanya M. Spruill

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to test the association between a self-report measure of 24-hour adherence to antihypertensive medication and blood pressure (BP) among African Americans. The primary analysis included 3558 Jackson Heart Study participants taking antihypertensive medication who had adherence data for at least one study examination. Nonadherence was defined by self-report of not taking one or more prescribed antihypertensive medications, identified during pill bottle review, in the past 24 hours. Nonadherence and clinic BP were assessed at Exam 1 (2000–2004), Exam 2 (2005–2008), and Exam 3 (2009–2013). Associations of nonadherence with clinic BP and uncontrolled BP (systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg) were evaluated using unadjusted and adjusted linear and Poisson repeated measures regression models. The prevalence of nonadherence to antihypertensive medications was 25.4% at Exam 1, 28.7% at Exam 2, and 28.5% at Exam 3. Nonadherence was associated with higher systolic BP (3.38 mm Hg) and diastolic BP (1.47 mm Hg) in fully adjusted repeated measures analysis. Nonadherence was also associated with uncontrolled BP (prevalence ratio = 1.26; 95% confidence interval = 1.16–1.37). This new self-report measure may be useful for identifying nonadherence to antihypertensive medication in future epidemiologic studies.

Original languageEnglish (US)
Pages (from-to)581-588.e5
JournalJournal of the American Society of Hypertension
Volume11
Issue number9
DOIs
StatePublished - Sep 1 2017

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African Americans
Antihypertensive Agents
Blood Pressure
Hypertension
Self Report
Epidemiologic Studies
Confidence Intervals

Keywords

  • blood pressure control
  • diastolic
  • hypertensive
  • JHS
  • Medication adherence
  • systolic

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study. / Butler, Mark J.; Tanner, Rikki M.; Muntner, Paul; Shimbo, Daichi; Bress, Adam P.; Shallcross, Amanda J.; Sims, Mario; Ogedegbe, Olugbenga; Spruill, Tanya M.

In: Journal of the American Society of Hypertension, Vol. 11, No. 9, 01.09.2017, p. 581-588.e5.

Research output: Contribution to journalArticle

Butler, Mark J. ; Tanner, Rikki M. ; Muntner, Paul ; Shimbo, Daichi ; Bress, Adam P. ; Shallcross, Amanda J. ; Sims, Mario ; Ogedegbe, Olugbenga ; Spruill, Tanya M. / Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study. In: Journal of the American Society of Hypertension. 2017 ; Vol. 11, No. 9. pp. 581-588.e5.
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