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Awareness of Being Prescribed Antihypertensive Medications and Cardiovascular Outcomes
Yuta Suzuki1,2, Hidehiro Kaneko1,3, Akira Okada4
1Department of Cardiovascular Medicine, The University of Tokyo.
Insights
Patients unaware they are taking blood pressure medication face a higher risk of cardiovascular disease (CVD), including heart attack and stroke. This highlights the importance of patient awareness for managing hypertension and preventing serious cardiac events.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension is a leading cause of cardiovascular disease (CVD).
- Lack of awareness about hypertension contributes to poor blood pressure control and elevated CVD risk.
- Nationwide data on unaware individuals and their clinical outcomes are limited.
Purpose of the Study:
- To investigate the association between unawareness of antihypertensive medication prescription and the risk of developing CVD.
- To clarify the clinical implications of unawareness among individuals treated for hypertension.
Main Methods:
- Retrospective cohort study using the JMDC Claims Database.
- Included 313,715 individuals with hypertension on antihypertensive medications.
- Primary endpoint: composite of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation.
Main Results:
- 6.2% of individuals were unaware of their antihypertensive prescriptions.
- Unawareness was linked to a higher risk of composite CVD events (HRs ranging from 1.15 to 1.36).
- This association persisted across sensitivity analyses, including those excluding individuals with dementia.
Conclusions:
- Assessing patient awareness of antihypertensive medication is crucial for identifying individuals at high risk for CVD events.
- Improving patient awareness may be a key strategy in hypertension management and CVD prevention.
Background:
Hypertension is a major cause of cardiovascular disease (CVD). In patients with hypertension, unawareness of the disease often results in poor blood pressure control and increases the risk of CVD. However, data in nationwide surveys regarding the proportion of unaware individuals and the implications of such on their clinical outcomes are lacking. We aimed to clarify the association between unawareness of being prescribed antihypertensive medications among individuals taking antihypertensive medications and the subsequent risk of developing CVD.
Methods And Results:
This retrospective cohort study analyzed data from the JMDC Claims Database, including 313,715 individuals with hypertension treated with antihypertensive medications (median age 56 years). The primary endpoint was a composite of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Overall, 19,607 (6.2%) individuals were unaware of being prescribed antihypertensive medications. During the follow-up period, 33,976 composite CVD endpoints were documented. Despite their youth, minimal comorbidities, and the achievement of better BP control with a reduced number of antihypertensive prescriptions, unawareness of being prescribed antihypertensive medications was associated with a greater risk of developing composite CVD. Hazard ratios of unawareness of being prescribed antihypertensive medications were 1.16 for myocardial infarction, 1.25 for angina pectoris, 1.15 for stroke, 1.36 for heart failure, and 1.28 for atrial fibrillation. The results were similar in several sensitivity analyses, including the analysis after excluding individuals with dementia.
Conclusions:
Among individuals taking antihypertensive medications, assessing the awareness of being prescribed antihypertensive medications may help identify those at high risk for CVD-related events.
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