{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:13:12Z","timestamp":1792807992450,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,11,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Medication nonadherence contributes to poor health outcomes but remains challenging to identify. This study assessed the association between self\u2010rated adherence and systolic blood pressure, low\u2010density lipoprotein cholesterol levels, cardiovascular events, and all\u2010cause mortality in SPRINT (Systolic Blood Pressure Intervention Trial).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A total of 9361 patients randomized to 2 systolic blood pressure target groups, &lt;120\u2009mm\u2009Hg (intensive) and &lt;140\u2009mm\u2009Hg (standard), self\u2010rated their medication adherence at each visit by marking a scale, ranging from 0% to 100%. Lower and high adherence were defined as scores \u226480% and &gt;80%, respectively. Linear mixed effect regression models and Cox proportional hazard models were used to evaluate the association between self\u2010rated adherence and systolic blood pressure and low\u2010density lipoprotein cholesterol\u00a0and cardiovascular events and all\u2010cause mortality, respectively. A total of 9278 participants (mean age 68\u00b19.4\u2009years, 35.6% female) had repeated self\u2010rated adherence measurements available, with a mean of 15\u00b14 measurements per participant over 3.8\u2009years follow\u2010up. Of these, 2694 participants (29.0%) had \u22651 adherence measurements \u226480%. Compared with high\u2010adherent patients, patients with lower adherence had significantly higher estimated on\u2010treatment systolic blood pressure at 2\u2010year follow\u2010up: 128.7 (95% CI, 127.6\u2013129.9) versus 120.0 (95% CI, 119.7\u2013120.2) mm\u2009Hg in the intensive arm; and 139.8 (95% CI 138.4\u2013141.1) versus 135.0 (95% CI 134.7\u2013135.2) in the standard arm. Moreover, lower adherence was associated with an estimated 11\u2009mg\/dL higher low\u2010density lipoprotein cholesterol level, more cardiovascular events (hazard ratio [HR], 1.69 [95% CI, 1.20\u20132.39]), and higher all\u2010cause mortality (HR, 1.63 [95% CI, 1.16\u20132.31]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Self\u2010rated adherence allows identification of lower medication adherence and correlates with blood pressure control, low\u2010density lipoprotein cholesterol levels, and adverse outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031418","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T10:17:01Z","timestamp":1699611421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Association Between Self\u2010Rated Medication Adherence and Adverse Cardiovascular Outcomes in Patients With Hypertension"],"prefix":"10.1161","volume":"12","author":[{"given":"Shirin","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9045-6009","authenticated-orcid":false,"given":"Nick S.","family":"Nurmohamed","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"},{"name":"Department of Cardiology, Amsterdam UMC Vrije Universiteit Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8572-8751","authenticated-orcid":false,"given":"Didier","family":"Collard","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"de Weger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8145-1676","authenticated-orcid":false,"given":"G. Kees","family":"Hovingh","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0943-4393","authenticated-orcid":false,"given":"Bert\u2010Jan H.","family":"van den Born","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-951X","authenticated-orcid":false,"given":"Laurens F.","family":"Reeskamp","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-6260","authenticated-orcid":false,"given":"Erik S. G.","family":"Stroes","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8379-7470","authenticated-orcid":false,"given":"Tom F.","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy377"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.034"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-5151(03)00091-4"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-020-01400-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmsr.2021.12.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016982"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.08.011"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-11-201212040-00538"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1331\/JAPhA.2008.07040"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000114908.90348.f9"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2016.08.009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.0634"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1477747"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.20.1.145"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13142-015-0315-2"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2307\/2955359"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpab145"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-5299.2003.03269.x"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu330"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht295"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu046"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.277064"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/967073"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3318"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1815359"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2208275"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615758"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0302-2"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1958-4"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001024"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000216"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90465-2"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318207ed9e"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-013-0642-6"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.123.031418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:35:57Z","timestamp":1715603757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.123.031418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,21]]},"references-count":35,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2023,11,21]]}},"alternative-id":["10.1161\/JAHA.123.031418"],"URL":"https:\/\/doi.org\/10.1161\/jaha.123.031418","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,21]]},"assertion":[{"value":"2023-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e031418"}}