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Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide

Mi-Hyang Jung1,2, So-Young Lee1,2, Jong-Chan Youn1,2

  • 1Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea.

Journal of the American Heart Association
|July 8, 2023
PubMed

Insights

Poor adherence to blood pressure medication significantly increases mortality risk in cancer patients. Improving medication adherence is crucial for better clinical outcomes in this vulnerable population.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Hypertension is a major risk factor for cardiovascular morbidity and mortality.
  • Cancer patients with hypertension face unique challenges in managing their cardiovascular health.
  • Antihypertensive medication adherence is critical for mitigating cardiovascular risks.

Purpose of the Study:

  • To investigate the association between adherence to antihypertensive medication and clinical outcomes in adult cancer patients.
  • To quantify the impact of medication adherence on overall mortality, cardiovascular mortality, and cardiovascular events.

Main Methods:

  • Retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort (2002-2013).
  • Included adult patients with cancer and hypertension treated with antihypertensive medications.
  • Categorized adherence into good (MPR ≥0.8), moderate (0.5≤ MPR <0.8), and poor (MPR <0.5) based on medication possession ratio (MPR).

Main Results:

  • Nonadherence was prevalent, with 66.4% of patients exhibiting moderate or poor adherence.
  • Compared to good adherence, moderate and poor adherence were associated with significantly increased risks of overall mortality (1.85-fold and 2.19-fold, respectively).
  • Poor adherence also elevated risks for cardiovascular mortality (1.71-fold) and new-onset cardiovascular events (1.34-fold).

Conclusions:

  • Nonadherence to antihypertensive medication is common among cancer patients with hypertension.
  • Suboptimal adherence is significantly linked to adverse clinical outcomes, including increased mortality and cardiovascular events.
  • Enhanced strategies to improve antihypertensive medication adherence are warranted for cancer patients.

Keywords:
adherencecancercardiovascular diseasehypertensionsurvivorship

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