Hennein R, et al. - Authors studied the risk factors for medication adherence as well as the association between adherence and levels of cardiovascular disease (CVD) risk factors among older participants with hypertension, dyslipidemia and diabetes. According to the results, depressive symptoms may serve as a barrier to medication adherence, which exacerbated CVD risk factors in older-aged adults.

Methods

• A total of 1,559 participants (median age 70 years, 53% women) were administered the four-item Morisky Medication Adherence Scale.
• An adherence score, ranging from 0 to 4, was developed with low adherence defined as a score ≥2.
• Using standard protocols, CVD risk factors were evaluated.
• The Mini-Mental State Examination (MMSE) was used to measure cognition and the Center for Epidemiologic Studies of Depression (CES-D) scale was used to measure depressive symptoms.

Results

• Twelve percent (n = 191) of participants who self-reported taking antihypertensive, lipid-lowering and/or hyperglycemic medication(s) had low medication adherence. A 45% increase was seen in the risk of low adherence (95% confidence interval (CI): 25-68%, P <0.001) per five-unit increase in CES-D score.
• Higher mean diastolic blood pressure (73 mmHg, 95% CI: 71-75 vs 71 mmHg, 95% CI: 70-71; P=0.04) was linked to low adherence among patients taking antihypertensives (n = 1017), after adjusting for covariates.
• Low adherence among participants taking lipid-lowering medication (n = 937) was linked to higher mean low-density lipoprotein cholesterol (92 mg/dL, 95% CI: 87-96 vs 86 mg/dL, 95% CI: 84-88; P=0.03).
• No link was found between low adherence with fasting plasma glucose (P=0.10) or hemoglobin A1c (P=0.68) in the subgroup of individuals (n = 192) taking hypoglycemic medication.