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. 2011 Jul;13(7):479-86.
doi: 10.1111/j.1751-7176.2011.00464.x. Epub 2011 Apr 22.

Low medication adherence and the incidence of stroke symptoms among individuals with hypertension: the REGARDS study

Paul Muntner  1 , Jewell H Halanych, Kristi Reynolds, Raegan Durant, Suma Vupputuri, Victor W Sung, James F Meschia, Virginia J Howard, Monika M Safford, Marie Krousel-Wood
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Low medication adherence and the incidence of stroke symptoms among individuals with hypertension: the REGARDS study

Paul Muntner et al. J Clin Hypertens (Greenwich). 2011 Jul.

Abstract

The authors analyzed data on 9950 participants taking antihypertensive medications in the nationwide Reasons for Geographic and Racial Differences in Stroke (REGARDS) study to determine the association between medication adherence and incident stroke symptoms. Medication adherence was assessed using a validated 4-item self-report scale and participants were categorized into 4 groups (scores of 0, 1, 2, and 3 or 4, with higher scores indicating worse adherence). The incidence of 6 stroke symptoms (sudden weakness on one side of the body, numbness, painless loss of vision in one or both eyes, loss of half vision, losing the ability to understand people, and losing the ability to express oneself verbally or in writing) was assessed via telephone interviews every 6 months. During a median of 4 years, the incidence of any stroke symptom was 14.6%, 17.9%, 20.2%, and 24.9% among participants with adherence scores of 0, 1, 2, and 3 or 4, respectively (P<.001). The multivariable adjusted hazard ratio (95% confidence interval) for any stroke symptom associated with adherence scores of 1, 2, and 3 or 4, vs 0, was 1.20 (1.04-1.39), 1.23 (0.94-1.60), and 1.59 (1.08-2.33), respectively (P<.001). Worse adherence was also associated with higher multivariable adjusted hazard ratios for each of the 6 stroke symptoms.

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Figures

Figure 1
Figure 1
Percent of Reasons for Geographic and Racial Differences in Stroke (REGARDS) study participants developing incident stroke symptoms during a median follow‐up of 4 years by level of medication adherence.
Figure 2
Figure 2
Number of incident stroke symptoms among Reasons for Geographic and Racial Differences in Stroke (REGARDS) study participants occurring during a median follow‐up of 4 years by level of medication adherence.
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