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Ability of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event

Low statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample o... Full description

Journal Title: The American journal of cardiology 2014, Vol.114 (6), p.826-831
Main Author: Muntner, Paul, PhD
Other Authors: Yun, Huifeng, MD, PhD , Sharma, Pradeep, MS , Delzell, Elizabeth, ScD , Kent, Shia T., PhD , Kilgore, Meredith L., PhD , Farkouh, Michael E., MD, MSc , Vupputuri, Suma, PhD , Bittner, Vera, MD , Rosenson, Robert S., MD , Levitan, Emily B., ScD , Safford, Monika M., MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/25103917
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title: Ability of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event
format: Article
creator:
  • Muntner, Paul, PhD
  • Yun, Huifeng, MD, PhD
  • Sharma, Pradeep, MS
  • Delzell, Elizabeth, ScD
  • Kent, Shia T., PhD
  • Kilgore, Meredith L., PhD
  • Farkouh, Michael E., MD, MSc
  • Vupputuri, Suma, PhD
  • Bittner, Vera, MD
  • Rosenson, Robert S., MD
  • Levitan, Emily B., ScD
  • Safford, Monika M., MD
subjects:
  • Abridged Index Medicus
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents - therapeutic use
  • Antihypertensive drugs
  • Cardiac patients
  • Cardiovascular
  • Cardiovascular disease
  • Coronary artery bypass
  • Coronary Artery Disease - complications
  • Coronary Artery Disease - drug therapy
  • Coronary heart disease
  • Drug therapy
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Health maintenance organizations
  • Heart attacks
  • Hospitalization
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
  • Hypertension - complications
  • Hypertension - drug therapy
  • Male
  • Medical research
  • Medicare
  • Medicare - statistics & numerical data
  • Medicine, Experimental
  • Older people
  • Patient compliance
  • Patient Compliance - statistics & numerical data
  • Prognosis
  • Retrospective Studies
  • Statins
  • United States
  • Withholding Treatment - trends
ispartof: The American journal of cardiology, 2014, Vol.114 (6), p.826-831
description: Low statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample of Medicare beneficiaries, we conducted a cohort study of Medicare beneficiaries initiating statins after hospitalization for acute myocardial infarction or coronary revascularization in 2007, 2008, and 2009. Antihypertensive medication adherence, defined using the average proportion of days covered across 5 classes during the 365 days before hospitalization, was categorized as ≥80% (high), 50% to
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleAbility of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event
creatorMuntner, Paul, PhD ; Yun, Huifeng, MD, PhD ; Sharma, Pradeep, MS ; Delzell, Elizabeth, ScD ; Kent, Shia T., PhD ; Kilgore, Meredith L., PhD ; Farkouh, Michael E., MD, MSc ; Vupputuri, Suma, PhD ; Bittner, Vera, MD ; Rosenson, Robert S., MD ; Levitan, Emily B., ScD ; Safford, Monika M., MD
creatorcontribMuntner, Paul, PhD ; Yun, Huifeng, MD, PhD ; Sharma, Pradeep, MS ; Delzell, Elizabeth, ScD ; Kent, Shia T., PhD ; Kilgore, Meredith L., PhD ; Farkouh, Michael E., MD, MSc ; Vupputuri, Suma, PhD ; Bittner, Vera, MD ; Rosenson, Robert S., MD ; Levitan, Emily B., ScD ; Safford, Monika M., MD
descriptionLow statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample of Medicare beneficiaries, we conducted a cohort study of Medicare beneficiaries initiating statins after hospitalization for acute myocardial infarction or coronary revascularization in 2007, 2008, and 2009. Antihypertensive medication adherence, defined using the average proportion of days covered across 5 classes during the 365 days before hospitalization, was categorized as ≥80% (high), 50% to <80% (medium), and <50% (low). Statin discontinuation was defined as failure to refill a statin within 365 days of hospital discharge, and low adherence was defined as proportion of days covered for statins <80%. In 2,695 Medicare beneficiaries who initiated statins after hospital discharge, 6.0%, 8.4%, and 14.5% with high, medium, and low antihypertensive medication adherence discontinued statins. After multivariable adjustment, the risk ratios (95% confidence interval) for statin discontinuation were 1.38 (0.98 to 1.95) and 2.41 (1.51 to 3.87) for beneficiaries with medium and low versus high antihypertensive medication adherence, respectively. In beneficiaries who did not discontinue statins, 36.2% had low statin adherence. Compared with high adherence, medium and low antihypertensive medication adherences were associated with multivariable adjusted risk ratios (95% confidence interval) for low statin adherence of 1.33 (1.14 to 1.55) and 1.62 (1.25 to 2.10), respectively. In conclusion, low antihypertensive medication adherence before initiating statins is associated with future statin discontinuation and low statin adherence.
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languageeng
publisherUnited States: Elsevier Inc
subjectAbridged Index Medicus ; Aged ; Aged, 80 and over ; Antihypertensive Agents - therapeutic use ; Antihypertensive drugs ; Cardiac patients ; Cardiovascular ; Cardiovascular disease ; Coronary artery bypass ; Coronary Artery Disease - complications ; Coronary Artery Disease - drug therapy ; Coronary heart disease ; Drug therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Health maintenance organizations ; Heart attacks ; Hospitalization ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hypertension - complications ; Hypertension - drug therapy ; Male ; Medical research ; Medicare ; Medicare - statistics & numerical data ; Medicine, Experimental ; Older people ; Patient compliance ; Patient Compliance - statistics & numerical data ; Prognosis ; Retrospective Studies ; Statins ; United States ; Withholding Treatment - trends
ispartofThe American journal of cardiology, 2014, Vol.114 (6), p.826-831
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1Yun, Huifeng, MD, PhD
2Sharma, Pradeep, MS
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4Kent, Shia T., PhD
5Kilgore, Meredith L., PhD
6Farkouh, Michael E., MD, MSc
7Vupputuri, Suma, PhD
8Bittner, Vera, MD
9Rosenson, Robert S., MD
10Levitan, Emily B., ScD
11Safford, Monika M., MD
title
0Ability of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event
1The American journal of cardiology
addtitleAm J Cardiol
descriptionLow statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample of Medicare beneficiaries, we conducted a cohort study of Medicare beneficiaries initiating statins after hospitalization for acute myocardial infarction or coronary revascularization in 2007, 2008, and 2009. Antihypertensive medication adherence, defined using the average proportion of days covered across 5 classes during the 365 days before hospitalization, was categorized as ≥80% (high), 50% to <80% (medium), and <50% (low). Statin discontinuation was defined as failure to refill a statin within 365 days of hospital discharge, and low adherence was defined as proportion of days covered for statins <80%. In 2,695 Medicare beneficiaries who initiated statins after hospital discharge, 6.0%, 8.4%, and 14.5% with high, medium, and low antihypertensive medication adherence discontinued statins. After multivariable adjustment, the risk ratios (95% confidence interval) for statin discontinuation were 1.38 (0.98 to 1.95) and 2.41 (1.51 to 3.87) for beneficiaries with medium and low versus high antihypertensive medication adherence, respectively. In beneficiaries who did not discontinue statins, 36.2% had low statin adherence. Compared with high adherence, medium and low antihypertensive medication adherences were associated with multivariable adjusted risk ratios (95% confidence interval) for low statin adherence of 1.33 (1.14 to 1.55) and 1.62 (1.25 to 2.10), respectively. In conclusion, low antihypertensive medication adherence before initiating statins is associated with future statin discontinuation and low statin adherence.
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7Cardiovascular disease
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20Hypertension - complications
21Hypertension - drug therapy
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24Medicare
25Medicare - statistics & numerical data
26Medicine, Experimental
27Older people
28Patient compliance
29Patient Compliance - statistics & numerical data
30Prognosis
31Retrospective Studies
32Statins
33United States
34Withholding Treatment - trends
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titleAbility of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event
authorMuntner, Paul, PhD ; Yun, Huifeng, MD, PhD ; Sharma, Pradeep, MS ; Delzell, Elizabeth, ScD ; Kent, Shia T., PhD ; Kilgore, Meredith L., PhD ; Farkouh, Michael E., MD, MSc ; Vupputuri, Suma, PhD ; Bittner, Vera, MD ; Rosenson, Robert S., MD ; Levitan, Emily B., ScD ; Safford, Monika M., MD
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0Abridged Index Medicus
1Aged
2Aged, 80 and over
3Antihypertensive Agents - therapeutic use
4Antihypertensive drugs
5Cardiac patients
6Cardiovascular
7Cardiovascular disease
8Coronary artery bypass
9Coronary Artery Disease - complications
10Coronary Artery Disease - drug therapy
11Coronary heart disease
12Drug therapy
13Drug Therapy, Combination
14Follow-Up Studies
15Health maintenance organizations
16Heart attacks
17Hospitalization
18Humans
19Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
20Hypertension - complications
21Hypertension - drug therapy
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23Medical research
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25Medicare - statistics & numerical data
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27Older people
28Patient compliance
29Patient Compliance - statistics & numerical data
30Prognosis
31Retrospective Studies
32Statins
33United States
34Withholding Treatment - trends
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6Farkouh, Michael E., MD, MSc
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8Bittner, Vera, MD
9Rosenson, Robert S., MD
10Levitan, Emily B., ScD
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6Farkouh, Michael E., MD, MSc
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atitleAbility of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event
jtitleThe American journal of cardiology
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abstractLow statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample of Medicare beneficiaries, we conducted a cohort study of Medicare beneficiaries initiating statins after hospitalization for acute myocardial infarction or coronary revascularization in 2007, 2008, and 2009. Antihypertensive medication adherence, defined using the average proportion of days covered across 5 classes during the 365 days before hospitalization, was categorized as ≥80% (high), 50% to <80% (medium), and <50% (low). Statin discontinuation was defined as failure to refill a statin within 365 days of hospital discharge, and low adherence was defined as proportion of days covered for statins <80%. In 2,695 Medicare beneficiaries who initiated statins after hospital discharge, 6.0%, 8.4%, and 14.5% with high, medium, and low antihypertensive medication adherence discontinued statins. After multivariable adjustment, the risk ratios (95% confidence interval) for statin discontinuation were 1.38 (0.98 to 1.95) and 2.41 (1.51 to 3.87) for beneficiaries with medium and low versus high antihypertensive medication adherence, respectively. In beneficiaries who did not discontinue statins, 36.2% had low statin adherence. Compared with high adherence, medium and low antihypertensive medication adherences were associated with multivariable adjusted risk ratios (95% confidence interval) for low statin adherence of 1.33 (1.14 to 1.55) and 1.62 (1.25 to 2.10), respectively. In conclusion, low antihypertensive medication adherence before initiating statins is associated with future statin discontinuation and low statin adherence.
copUnited States
pubElsevier Inc
pmid25103917
doi10.1016/j.amjcard.2014.06.009