title: Prevalence and correlates of low medication adherence in apparent treatment-resistant hypertension.
abstract: Low medication adherence may explain part of the high prevalence of apparent treatment-resistant hypertension (aTRH). The authors assessed medication adherence and aTRH among 4026 participants taking ≥ 3 classes of antihypertensive medication in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) trial using the 4-item Morisky Medication Adherence Scale (MMAS). Low adherence was defined as an MMAS score ≥ 2. Overall, 66% of participants taking ≥ 3 classes of antihypertensive medication had aTRH. Perfect adherence on the MMAS was reported by 67.8% and 70.9% of participants with and without aTRH, respectively. Low adherence was present among 8.1% of participants with aTRH and 5.0% of those without aTRH (P<.001). Among those with aTRH, female sex, residence outside the US stroke belt or stroke buckle, physical inactivity, elevated depressive symptoms, and a history of coronary heart disease were associated with low adherence. In the current study, a small percentage of participants with aTRH had low adherence.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA. irvinr@uab.edu
authors.forename: Marguerite R
authors.initials: MR
authors.lastname: Irvin
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Devin M
authors.initials: DM
authors.lastname: Mann
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Marie
authors.initials: M
authors.lastname: Krousel-Wood
authors.forename: Nita A
authors.initials: NA
authors.lastname: Limdi
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
authors.forename: David A
authors.initials: DA
authors.lastname: Calhoun
authors.forename: Suzanne
authors.initials: S
authors.lastname: Oparil
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D005843:Geography; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D055118:Medication Adherence; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D013223:Statistics as Topic; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents