Hennein R, et al. - In the Framingham Heart Study, risk factors for medication adherence and the relationship between adherence and levels of cardiovascular disease (CVD) risk factors were examined among older participants with hypertension, dyslipidemia, and diabetes. For medication adherence, depressive symptoms could act as a barrier, which exacerbated CVD risk factors in older-aged adults.

Methods

• The clinicians administered 4-item Morisky Medication Adherence Scale to 1,559 participants, median age 70 years, 53% women.
• With low adherence defined as a score ≥2, they created an adherence score, ranging from 0-4.
• Using standard protocols, CVD risk factors were evaluated.
• They measured cognition using the Mini-Mental State Examination (MMSE).
• Using the Center for Epidemiologic Studies of Depression (CES-D) scale, depressive symptoms were measured.

Results

• Twelve percent participants (n=191) had low medication adherence among participants who self-reported taking antihypertensive, lipid-lowering, and/or hyperglycemic medication(s).
• In this study, the risk of low adherence increased by 45% (9%CI: 25-68%, P < 0.001) per five-unit increase in CES-D score.
• After adjusting for covariates, low adherence was correlated with higher mean diastolic blood pressure (73 mmHg, 95%CI: 71-75 vs 71 mmHg, 95CI: 70-71; P=0.04) in participants taking antihypertensive medication (n=1,017).
• Low adherence was associated with higher mean low-density lipoprotein cholesterol (92 mg/dL, 95%CI: 87-96 vs 86 mg/dL, 95%CI: 84-88; P=0.03) among participants taking lipid-lowering medication (n=937).
• In the subgroup of participants (n=192) taking hypoglycemic medication, low adherence was not correlated with fasting plasma glucose (P=0.10) or hemoglobin A1c (P=0.68).