BP medication adherence may decrease mortality risk in older patients
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The risk for death significantly decreased in older patients who adhered to antihypertensive treatment, according to a study published in Hypertension.
“This is the case also in elderly patients with a high rate of comorbidities and a short life expectancy, although in these patients, the benefit appears to be less than that in patients in good clinical conditions,” Federico Rea, PhD, statistician and collaborator of the department of statistics and quantitative methods at the University of Milano-Bicocca in Italy, and colleagues wrote.
Researchers analyzed data from 1,283,602 Italian patients aged at least 65 years (mean age, 76 years) who were taking three or more antihypertensive medications from 2011 to 2012. A prognostic index was used to assess the link between 34 weighted CV and non-CV conditions and mortality. This information was used to calculate a multisource comorbidity score to categorize patients by clinical status: good (0-4; n = 324,966; mean age, 75 years; 39% men), medium (5-9; n = 482,937; mean age, 75 years; 40% men), poor (10-14; n = 395,721; mean age, 78 years; 44% men) or very poor ( 15; n = 79,978; mean age, 78 years; 51% men).
Proportion of days covered quantified adherence to antihypertensive medications. Patients were also categorized as very low, low, intermediate and high adherence.
Researchers also performed a case-control study to assess all-cause and CV mortality. In this analysis, 254,778 cases were matched with controls (mean age, 81 years; 46% men).
There were 255,228 deaths during 7,579,381 person-years of observation or a median follow-up of 84 months. The probability of death increased from 16% in patients with good clinical status to 64% in those with very poor clinical status.
Patients with high adherence had a lower risk for all-cause mortality according to clinical status at baseline: good (44%), medium (43%), poor (40%) or very poor (33%; P for trend = .046). CV death also had similar figures for good (41%), medium (34%), poor (23%) or very poor clinical status (14%).
“Do your best to encourage and support patients to take their medications because adherence is crucial to getting the benefits,” Giuseppe Mancia, MD, professor emeritus at the University of Milano-Bicocca, said in a press release. “Medications do nothing if people don’t take them.”
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