Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr;61(4):558-64.
doi: 10.1111/jgs.12171. Epub 2013 Mar 25.

Sex differences in barriers to antihypertensive medication adherence: findings from the cohort study of medication adherence among older adults

Elizabeth Holt  1 , Cara Joyce, Adriana Dornelles, Donald Morisky, Larry S Webber, Paul Muntner, Marie Krousel-Wood
Affiliations

Sex differences in barriers to antihypertensive medication adherence: findings from the cohort study of medication adherence among older adults

Elizabeth Holt et al. J Am Geriatr Soc. 2013 Apr.

Abstract

Objectives: To determine whether sociodemographic, clinical, healthcare system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores in older men and women.

Design: Cross-sectional analysis of baseline data.

Setting: Cohort Study of Medication Adherence in Older Adults (N = 2,194).

Measurements: Low antihypertensive medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale. Information on risk factors for low adherence was collected using telephone surveys and administrative databases.

Results: The prevalence of low medication adherence scores did not differ according to sex (women, 15.0%; men 13.1%; P = .21). In sex-specific multivariable models, having problems with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores in men and women. Factors associated with low adherence scores in men but not women were poor sexual functioning (odds ratio (OR) = 2.03, 95% confidence interval (CI) = 1.31-3.16 for men and OR = 1.28, 95% CI = 0.90-1.82 for women), and body mass index of 25.0 kg/m(2) or more (OR = 3.23, 95% CI = 1.59-6.59 for men; OR = 1.23, 95% CI = 0.82-1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75, 95% CI = 1.16-2.65 for women; OR = 1.16, 95% CI = 0.57-2.34 for men) and depressive symptoms (OR = 2.29, 95% CI = 1.55-3.38 for women; OR = 0.93, 95% CI = 0.48-1.80 for men).

Conclusion: Factors associated with low antihypertensive medication adherence scores differed according to sex. Interventions designed to improve adherence in older adults should be customized to account for the sex of the target population.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest:

Dr. Krousel-Wood receives grant money from the NIH to support Ochsner’s participation in the SPRINT trial (blood pressure lowering trial). She is also a member of the NIH Center for Scientific Review Advisory Council.

Dr. Morisky is the developer/owner of the copyrighted MMAS-8 which is available free through a license agreement for publicly-funded researchers and students. Permission for use of MMAS-8 is required. Licensure agreement is available from Dr. Donald E. Morisky, Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health.

References

    1. Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1999 to 2000: A rising tide. Hypertension. 2004;44:398–404. - PubMed
    1. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010;303:2043–2050. - PubMed
    1. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. JAMA. 2003;289:2560–2572. - PubMed
    1. Munger MA, Van Tassell BW, LaFleur J. Medication nonadherence: an unrecognized cardiovascular risk factor. Med Gen Med. 2007;9:58. - PMC - PubMed
    1. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487–497. - PubMed

Publication types

Substances