Adherence to antihypertensive medication and cardiovascular disease events in hypertensive patients: a dose-response meta-analysis of 2 769 700 participants in cohort study.

Abstract

BACKGROUND:

Recently, many studies have investigated the association between adherence to antihypertensive medication (AHM) and risk of cardiovascular disease (CVD) events for hypertensive patients; however, the results varied by different studies.

AIMS:

The purpose of our meta-analysis was to explore the comprehensively summarized association between AHM adherence and risk of CVD events in hypertensive patients from cohort studies.

DESIGN:

A dose-response meta-analysis.

METHODS AND RESULTS:

We conducted a systematic search in two databases (PubMed and Embase) from 1974 to 15 December 2019 to identify English-language reports that assessed the association of AHM adherence with risk of CVD events in cohort studies. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS:

We included 16 cohort studies with 2 769 700 participants in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.56-0.78, I2 = 98.6%) for the highest versus lowest AHM adherence categories. We found a linear dose-response association of AHM adherence and CVD events (Pnonlinearity = 0.887), each 20% increase in AHM adherence was associated with a 13% reduced risk of CVD events (RR 0.87, 95% CI 0.83-0.92, I2 = 98.2%) in hypertensive patients.

CONCLUSION:

High AHM adherence has a protective effect on CVD events for hypertensive patients, and improving medication adherence may provide long-term CVD benefits.

• Authors: Y Feng, Y Zhao, X Yang, Y Li, M Han, R Qie, S Huang, X Wu, Y Zhang, Y Wu, D Liu, D Zhang, C Cheng, F Hu, M Zhang, Y Yang, X Shi, L Sun, Dongsheng Hu
• Journal: QJM : monthly journal of the Association of Physicians (QJM) Vol. 115 Issue 5 Pg. 279-286 (May 10 2022) ISSN: 1460-2393 [Electronic] England
• PMID: 33459791 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Antihypertensive Agents

Topics

• Antihypertensive Agents (therapeutic use)
• Cardiovascular Diseases (drug therapy, epidemiology, prevention & control)
• Cohort Studies
• Humans
• Hypertension (complications, drug therapy)
• Medication Adherence