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          <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Adherence to study medications is crucial to evaluating treatment effects in clinical trials. To assess whether in the SPRINT trial, adherence and cardiovascular outcomes are associated regardless of intervention assignment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This study included 9,361 participants aged \u226550 years, recruited from 102 clinics. Participants were randomized to a Standard Treatment Group (targeted systolic blood pressure [SBP] &amp;lt;140 mm Hg) or an Intensive Treatment Group (targeted SBP &amp;lt;120 mm Hg) and followed for incident cardiovascular events until the study was halted early for benefit. The 8-item Morisky Medication Adherence Scale (MMAS-8) was administered at baseline, and at the 12- and 48-month (or close out) visit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Adjusting for covariates, there was no association between the baseline 8-item MMAS-8 and the likelihood of the primary composite endpoint, any of the secondary endpoints, or blood pressure (BP) control. Low adherence was associated with a higher body mass index, SBP, diastolic BP, and Patient Health Questionnaire, and high adherence was associated with a higher Montreal Cognitive Assessment. There was no difference in the MMAS-8 over time by treatment arm assignment. For the primary outcome (a composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes), baseline odds ratios (95% confidence intervals) for the Low vs. Medium and vs. High; and, for Medium vs. High MMAS-8 were 1.02 (0.82\u20131.28), 1.07 (0.85\u20131.34), and 1.05 (0.88\u20131.250).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In SPRINT, medication adherence as measured using the MMAS-8 was not associated with outcomes or BP control.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpab145","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T11:15:43Z","timestamp":1631618143000},"page":"182-191","source":"Crossref","is-referenced-by-count":12,"title":["Is Medication Adherence Predictive of Cardiovascular Outcomes and Blood Pressure Control? The Systolic Blood Pressure Intervention Trial (SPRINT)"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-6406","authenticated-orcid":false,"given":"Stephen P","family":"Glasser","sequence":"first","affiliation":[{"name":"Department of Medicine (Cardiology), University of Kentucky , Lexington, Kentucky , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Vitolins","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Prevention, Wake Forest School of Medicine , Winston-Salem, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael V","family":"Rocco","sequence":"additional","affiliation":[{"name":"Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine , Winston-Salem, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn Harmon","family":"Still","sequence":"additional","affiliation":[{"name":"Frances Payne Bolton, School of Nursing, Case Western Reserve University , Cleveland, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey S","family":"Cofield","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham , Birmingham, Alabama , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E","family":"Haley","sequence":"additional","affiliation":[{"name":"Mayo Clinic Division of Nephrology and Hypertension , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goff","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute (NIH\/NHLBI) , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"2023120723270380500_CIT0001","doi-asserted-by":"crossref","first-page":"e003827","DOI":"10.1161\/JAHA.116.003827","article-title":"Meta-analysis of medication adherence interventions among heart failure patients: the lumpers make their case","volume":"5","author":"Osterberg","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2023120723270380500_CIT0002","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.pcad.2020.08.003","article-title":"Medication adherence: importance, issues and policy: a policy statement from the American Heart Association","volume":"64","author":"Pina","year":"2021","journal-title":"Prog Cardiovasc Dis"},{"key":"2023120723270380500_CIT0003","first-page":"1504","article-title":"Drugs don\u2019t work in people who don\u2019t take them","volume":"20","author":"Glasser","year":"2018","journal-title":"JCH"},{"key":"2023120723270380500_CIT0004","doi-asserted-by":"crossref","first-page":"e002606","DOI":"10.1161\/JAHA.115.002606","article-title":"Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta-analysis of controlled trials","volume":"5","author":"Ruppar","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2023120723270380500_CIT0005","doi-asserted-by":"crossref","first-page":"e003827","DOI":"10.1161\/JAHA.116.003827","article-title":"Meta-analysis of medication adherence interventions among heart failure patients: the lumpers make their case","volume":"5","author":"Khazanie","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2023120723270380500_CIT0006","doi-asserted-by":"crossref","first-page":"e0196138","DOI":"10.1371\/journal.pone.0196138","article-title":"Correction: accuracy of a screening tool for medication adherence: a systematic review and meta-analysis of the Morisky Medication Adherence Scale-8","volume":"13","author":"Moon","year":"2018","journal-title":"PLoS One"},{"key":"2023120723270380500_CIT0007","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1177\/1740774514537404","article-title":"The design and rationale of a multi-center clinical trial comparing two strategies for control of systolic blood pressure: the Systolic Blood Pressure Intervention Trial (SPRINT)","volume":"11","author":"Ambrosius","year":"2014","journal-title":"Clin Trials"},{"key":"2023120723270380500_CIT0008","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1161\/HYPERTENSIONAHA.117.10479","article-title":"Blood pressure measurement in SPRINT (Systolic Blood Pressure Intervention Trial)","volume":"71","author":"Johnson","year":"2018","journal-title":"Hypertension"},{"key":"2023120723270380500_CIT0009","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1161\/01.CIR.0000100560.46946.EA","article-title":"Case definitions for acute coronary heart disease in epidemiology and clinical research studies: a statement from the AHA Council on Epidemiology and Prevention; 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