BACKGROUND: Low adherence to antihypertensive medication is an important barrier to achieving blood pressure control. Few data are available for medication adherence in adults with chronic kidney disease (CKD). STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: 3,936 and 9,129 participants with and without CKD using antihypertensive medication in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, respectively. CKD was defined as albuminuria with albumin excretion>or=30 mg/g or estimated glomerular filtration rate<60 mL/min/1.73 m2. OUTCOMES: Medication adherence and uncontrolled hypertension. MEASUREMENTS: Medication adherence was assessed using a validated 4-item scale. Blood pressure was measured 2 times by trained staff. RESULTS: In REGARDS participants with and without CKD, 1,426 (36.2%) and 2,421 (26.5%) had uncontrolled hypertension with blood pressure>or=140/90 mm Hg, and 2,656 (67.5%) and 5,627 (61.6%), >or=130/80 mm Hg. Also, 27.7% of those with CKD and 27.9% of those without CKD responded "yes" to ever forgetting to take their medication and 4.4% and 4.2%, respectively, responded yes to being careless about taking their medication. Also, 5.7% and 5.3% responded yes to missing taking medication when they felt better, and 4.2% and 3.6%, to missing it when they felt sick. Overall, 23.3% and 23.7% of participants with and without CKD responded yes to 1 adherence question, whereas 7.7% and 7.2%, respectively, responded yes to 2 or more adherence questions. In those with CKD, the multivariable adjusted ORs for uncontrolled hypertension (blood pressure>or=140/90 mm Hg) for individuals answering yes to 1 and 2 or more versus 0 adherence questions were 1.26 (95% CI, 1.05-1.51) and 1.49 (95% CI, 1.12-1.98), respectively. Analogous ORs for systolic/diastolic blood pressure>or=130/80 mm Hg were 1.06 (95% CI, 0.78-1.45) and 1.20 (95% CI, 0.88-1.64). LIMITATIONS: Pharmacy fill data were not available. CONCLUSIONS: Individuals with CKD had similarly poor medication-taking behaviors as those without CKD. Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Low adherence to antihypertensive medication is an important barrier to achieving blood pressure control. Few data are available for medication adherence in adults with chronic kidney disease (CKD). STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: 3,936 and 9,129 participants with and without CKD using antihypertensive medication in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, respectively. CKD was defined as albuminuria with albumin excretion>or=30 mg/g or estimated glomerular filtration rate<60 mL/min/1.73 m2. OUTCOMES: Medication adherence and uncontrolled hypertension. MEASUREMENTS: Medication adherence was assessed using a validated 4-item scale. Blood pressure was measured 2 times by trained staff. RESULTS: In REGARDS participants with and without CKD, 1,426 (36.2%) and 2,421 (26.5%) had uncontrolled hypertension with blood pressure>or=140/90 mm Hg, and 2,656 (67.5%) and 5,627 (61.6%), >or=130/80 mm Hg. Also, 27.7% of those with CKD and 27.9% of those without CKD responded "yes" to ever forgetting to take their medication and 4.4% and 4.2%, respectively, responded yes to being careless about taking their medication. Also, 5.7% and 5.3% responded yes to missing taking medication when they felt better, and 4.2% and 3.6%, to missing it when they felt sick. Overall, 23.3% and 23.7% of participants with and without CKD responded yes to 1 adherence question, whereas 7.7% and 7.2%, respectively, responded yes to 2 or more adherence questions. In those with CKD, the multivariable adjusted ORs for uncontrolled hypertension (blood pressure>or=140/90 mm Hg) for individuals answering yes to 1 and 2 or more versus 0 adherence questions were 1.26 (95% CI, 1.05-1.51) and 1.49 (95% CI, 1.12-1.98), respectively. Analogous ORs for systolic/diastolic blood pressure>or=130/80 mm Hg were 1.06 (95% CI, 0.78-1.45) and 1.20 (95% CI, 0.88-1.64). LIMITATIONS: Pharmacy fill data were not available. CONCLUSIONS: Individuals with CKD had similarly poor medication-taking behaviors as those without CKD. Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Authors: Carmen A Peralta; Leroi S Hicks; Glenn M Chertow; John Z Ayanian; Eric Vittinghoff; Feng Lin; Michael G Shlipak Journal: Hypertension Date: 2005-04-25 Impact factor: 10.190
Authors: Philip S Wang; Rhonda L Bohn; Eric Knight; Robert J Glynn; Helen Mogun; Jerry Avorn Journal: J Gen Intern Med Date: 2002-07 Impact factor: 5.128
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Christopher M Callahan; Frederick W Unverzagt; Siu L Hui; Anthony J Perkins; Hugh C Hendrie Journal: Med Care Date: 2002-09 Impact factor: 2.983
Authors: Gabriel S Tajeu; Shia T Kent; Ian M Kronish; Lei Huang; Marie Krousel-Wood; Adam P Bress; Daichi Shimbo; Paul Muntner Journal: Hypertension Date: 2016-07-18 Impact factor: 10.190
Authors: Kailin L Hsu; Jeffrey C Fink; Jennifer S Ginsberg; Marni Yoffe; Min Zhan; Wanda Fink; Corinne M Woods; Clarissa J Diamantidis Journal: Am J Kidney Dis Date: 2015-05-13 Impact factor: 8.860
Authors: Paul Muntner; Jewell H Halanych; Kristi Reynolds; Raegan Durant; Suma Vupputuri; Victor W Sung; James F Meschia; Virginia J Howard; Monika M Safford; Marie Krousel-Wood Journal: J Clin Hypertens (Greenwich) Date: 2011-04-22 Impact factor: 3.738