{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:52:37Z","timestamp":1791874357064,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Understanding class\u2010specific antihypertensive adherence is crucial for optimizing hypertension management. This retrospective cohort study analyzed adherence to antihypertensive medication among commercially insured adults (18\u201364 years) from 2018 to 2023 using Merative MarketScan data. Adherence was defined as the proportion of days covered (PDC) \u2265 80%. Among 2\u00a0770\u00a0855 hypertensive patients with single\u2010pill therapy, the majority were older (43% aged 55\u201364 years) and predominantly male (53%). The South had the highest prevalence of hypertension (53%). Overall adherence improved significantly from 56.61% in 2018\u20132019 to 75.55% in 2022\u20132023 across all medication classes. Patients receiving angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blocker (ACEi\/ARB) combination therapies had the highest adherence rate (79.18%), while diuretics (67.58%) and \u201cOther Drugs\u201d (57.38%) had the lowest in 2022\u20132023. Logistic regression showed that younger patients (18\u201334 years) were significantly less adherent than older adults (OR\u00a0=\u00a00.434, 95% CI: 0.420\u20130.448). Males were more likely to adhere than females (OR = 1.142, 95% CI: 1.129\u20131.156). Regional variations were notable, with patients in the Northeast exhibiting 15% higher adherence than those in the West. Insurance types also influenced adherence, with managed care plan enrollees showing better adherence than those in fee\u2010for\u2010service plans (OR\u00a0=\u00a01.165, 95% CI: 1.151\u20131.179). Surprisingly, prescription refill monitoring reduced adherence, decreasing odds by 52% (OR\u00a0=\u00a00.482, 95% CI: 0.470\u20130.490). Monotherapy and combination therapy users differed significantly across all demographics (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). Higher comorbidity burden correlated with lower adherence, with diabetes being most prevalent among users of diuretics (12.88%), beta\u2010blockers (12.8%), and other antihypertensives (26.01%). These findings highlight the multifaceted barriers to antihypertensive adherence and emphasize the need for targeted interventions that address medication\u2010specific and patient\u2010specific factors.<\/jats:p>","DOI":"10.1111\/jch.70108","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T09:00:01Z","timestamp":1754125201000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trends and Predictors of Antihypertensive Medication Adherence in Commercially Insured Adults under 65 (2018\u20132023)"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3190-7038","authenticated-orcid":false,"given":"N. M. Mahmudul Alam","family":"Bhuiya","sequence":"first","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy College of Pharmacy University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Caballero","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy College of Pharmacy University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry N.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy College of Pharmacy University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Villa Zapata","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy College of Pharmacy University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006056"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd16.180381"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.037357"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.07720"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.12495"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0242467"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.983874"},{"issue":"7","key":"e_1_2_10_10_1","article-title":"First\u2010Line Diuretics Versus Other Classes of Antihypertensive Drugs for Hypertension","volume":"7","author":"Reinhart M.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2020.02698"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15781"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2021.11.013"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-064284"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000915088.11907.db"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd9070202"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1101\/2024.07.31.24311323"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.04.060"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.263"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.830299"},{"issue":"7","key":"e_1_2_10_21_1","first-page":"457","article-title":"Measuring Concurrent Adherence to Multiple Related Medications","volume":"15","author":"Choudhry N. 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