title: Antihypertensive medication persistence 1-year post-stroke hospitalization.
abstract: To optimize the translation of clinical trial evidence that antihypertensive treatment reduces recurrent stroke risk into clinical practice, it is important to assess the frequency of long-term antihypertensive drug persistence after stroke and identify the factors associated with low persistence. Structured telephone interviews to determine antihypertensive regimen persistence 1-year post-stroke hospitalization were conducted in 270 stroke survivors, of which 212 (78.5%) were discharged on antihypertensive therapy (two thirds on >1 drug class). Continued use of any antihypertensive agent at 1 year of follow-up was relatively high (87.3%); however, persistence on all or two or more drug classes prescribed at discharge was relatively low (38.7%). Continued use varied by drug class, with the highest rates among angiotensin-converting enzyme inhibitor (69.1%) and the lowest rates among diuretic (24.4%) users. Black patients (adjusted odds ratio, 0.35; 95% confidence interval, 0.16-0.78) and those with a high comorbidity burden (adjusted odds ratio , 0.39; 95% confidence interval, 0.18-0.86) were less likely to exhibit persistence on prescribed treatments 1-year post-stroke hospitalization. These results indicate the need for further study to identify appropriate persistence of antihypertensive therapies for secondary stroke prevention and to investigate reasons for racial disparities in persistence on prescribed treatments in a real-world clinical setting.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, SC; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Boan
authors.forename: Brent M
authors.initials: BM
authors.lastname: Egan
authors.forename: David L
authors.initials: DL
authors.lastname: Bachman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Adams
authors.forename: Wuwei Wayne
authors.initials: WW
authors.lastname: Feng
authors.forename: Edward C
authors.initials: EC
authors.lastname: Jauch
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000517:prevention & control*; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents