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Adherence to cardio-protective medications and cardiovascular disease in adults with type 1 diabetes

Raija Lithovius1, Stefan Mutter1, Erika B Parente1

  • 1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland.

Diabetes Research and Clinical Practice
|July 28, 2024
PubMed

Insights

Good adherence to cardiovascular medications in type 1 diabetes patients significantly lowers cardiovascular disease (CVD) risk. Improving medication adherence is crucial for better patient outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Type 1 diabetes (T1D) patients have an increased risk of cardiovascular disease (CVD).
  • Antihypertensive (AHT) and lipid-lowering drugs are vital for managing CVD risk in T1D.
  • Kidney disease is a common complication and risk factor for CVD in T1D.

Purpose of the Study:

  • To estimate medication refill adherence to AHT and/or lipid-lowering drugs in T1D adults.
  • To investigate the association between adherence and CVD incidence, considering kidney disease.

Main Methods:

  • Finnish Diabetic Nephropathy Study included 1,558 adults with T1D.
  • Medication adherence was assessed using the Proportion of Days Covered (PDC) method.
  • Adherence was categorized as good (≥80%), intermediate (50-79%), or poor (<50%).

Main Results:

  • Median adherence rate was 74%.
  • Both good and intermediate adherence were associated with significantly lower odds of CVD compared to poor adherence.
  • In patients with moderate albuminuria, higher adherence correlated with reduced CVD odds.

Conclusions:

  • Refill adherence of 50% or more to cardio-protective medications is linked to reduced CVD risk in T1D adults.
  • Ensuring and improving medication adherence is critical for preventing CVD in this population.
  • Findings underscore the importance of adherence beyond initial prescription of CVD-protective drugs.
Abstract

Keywords:
Antihypertensive drugsCardiovascular diseaseDiabetic kidney diseaseLipid-lowering drugsMedication adherenceType 1 diabetes

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