Related Experiment Videos
Racial differences in adherence to cardiac medications
Hyasmine Charles1, Chester B Good, Barbara H Hanusa
1Division of General Internal Medicine, University of Pittsburgh and Pittsburgh VA Medical Center, Pittsburgh, Pennsylvania, USA.
Insights
Younger African Americans showed lower adherence to cardiac medications like ACE inhibitors, CCBs, and statins compared to white veterans. This disparity, observed even with minimal financial barriers, may contribute to cardiovascular health differences.
Area of Science:
- Cardiology
- Health Services Research
- Pharmacology
Background:
- Medication adherence is crucial for managing cardiovascular disease.
- Racial disparities in cardiovascular disease outcomes persist in the United States.
- Understanding adherence patterns across racial groups is essential for targeted interventions.
Purpose of the Study:
- To investigate potential racial differences in adherence to key cardiac medications.
- To examine adherence rates for angiotensin-converting enzyme inhibitors (ACEIs), beta-blockers (BBs), calcium channel blockers (CCBs), and statins.
Main Methods:
- Retrospective analysis of administrative records from male veterans aged 45 years and older.
- Identified African-American and white veterans prescribed ACEIs, BBs, CCBs, or statins.
- Defined adherence as obtaining medication for 80% of prescribed days.
Main Results:
- African Americans were less adherent to ACEIs, CCBs, and statins compared to white veterans.
- No significant difference in adherence to beta-blockers was observed between racial groups.
- Racial differences in adherence were most pronounced in veterans younger than 55 years old.
Conclusions:
- Younger African-American veterans demonstrated lower medication adherence than their white counterparts.
- These findings suggest that factors beyond financial barriers may influence adherence in younger African Americans.
- Addressing adherence disparities is critical to mitigating cardiovascular morbidity in African-American populations.
Objective:
To determine whether there are racial differences in adherence to cardiac medications.
Design:
Retrospective analysis.
Patients:
African-American and white male veterans aged 45 years or older who had received any of four groups of drugs: angiotensin-converting enzyme inhibitors (ACEIs), beta-blockers (BBs), calcium channel blockers (CCBs,) or HMG CoA (hydroxymethyl glutaryl coenzyme A) reductase inhibitors (statins).
Data:
Administrative records were used to identify eligible veterans and their demographic characteristics, medical diagnoses, and medication use. We used a standard measure of adherence to medications based on whether the veteran obtained enough drug to take it as prescribed on 80% of the days.
Results:
We identified 833 eligible African-American and 4436 eligible white veterans. In univariable analysis, African Americans were less likely to be adherent to medications than whites for ACEIs (81.4% versus 87.6%, P = 0.004), CCBs (75.3% versus 81.7%, P = 0.003), and statins (59.9% versus 74.1%, P < 0.001) but not BBs (84.8% versus 83.5%, P = 0.6). In multivariable analysis, racial differences in adherence to medications were found primarily among veterans younger than 55 years old.
Conclusions:
Younger African Americans were less adherent to medications than whites in a setting where financial barriers are minimized. Although the reason for this finding is unclear, it may contribute to high cardiovascular morbidity among African Americans.
Related Concept Videos
01:24Drug Toxicity: Risk factors
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:29Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:22Heart Failure Drugs: β-Blockers