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BP medication adherence less likely in patients with PTSD
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Patients with uncontrolled hypertension are less likely to adhere to BP medication if they have symptoms of posttraumatic stress disorder, according to recent study data.
Researchers evaluated symptoms of posttraumatic stress disorder (PTSD) among 114 patients with uncontrolled hypertension, based on elevated BP on two consecutive visits before enrollment. Participants were enrolled from a primary care facility in New York City between Nov. 1, 2011, and June 30, 2013. BP medication adherence was assessed by use of an electronic pillbox between two clinic visits (mean duration, 56 days). Nonadherence was defined as adherence to the treatment regimen for fewer than 80% of days during assessment.
Participants had been prescribed a mean of 2.6 BP medications. Among 98 patients with evaluable pillbox data, the median adherence was 86%. Forty-one percent of participants were considered nonadherent.
Twenty-one percent of participants reported one or two symptoms of PTSD, 19% reported three or four symptoms and 59% reported no symptoms. Nonadherence to BP medication was reported in 68% of participants with PTSD compared with 26% of those without PTSD (P=.001).
After adjustment for factors including age, sex, race/ethnicity, number of medications and depression, patients with PTSD symptoms were significantly less likely to adhere to treatment than those with no symptoms (adjusted OR=4.22; 95% CI, 1.33-13.51 for one or two symptoms; adjusted OR=5.18; 95% CI, 1.1-24.39 for three or four symptoms).
“To our knowledge, this study is the first to demonstrate that PTSD is an independent risk factor for nonadherence among patients with uncontrolled hypertension and offers and potential mechanism by which PTSD is associated with CV disease,” the researchers concluded. “… Given the prevalence of PTSD and its strong association with medication nonadherence, our findings provide impetus to evaluate the benefit of enhanced screening and treatment for PTSD in medical settings to improve CV risk in these patients.”
Disclosure: The researchers report no relevant financial disclosures.
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