Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis
BackgroundInconsistent findings have been obtained for previous studies evaluating the association between antihypertensive medication (AHM) adherence and the risk of stroke. This dose‐response meta‐analysis was designed to investigate the association between AHM adherence and stroke risk. Methods a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.006371 |
| _version_ | 1818398633009086464 |
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| author | Tao Xu Xinyuan Yu Shu Ou Xi Liu Jinxian Yuan Xinjie Tan Yangmei Chen |
| author_facet | Tao Xu Xinyuan Yu Shu Ou Xi Liu Jinxian Yuan Xinjie Tan Yangmei Chen |
| author_sort | Tao Xu |
| collection | DOAJ |
| description | BackgroundInconsistent findings have been obtained for previous studies evaluating the association between antihypertensive medication (AHM) adherence and the risk of stroke. This dose‐response meta‐analysis was designed to investigate the association between AHM adherence and stroke risk. Methods and ResultsMEDLINE and Embase databases were systematically searched to identify relevant studies. The quantification of adherence to AHM was calculated as the percentage of the sum of days with AHM actually taken divided by the total number of days in a specific period. Summary relative risks (RR) and 95% CIs were estimated using a random‐effects model. Stratified and dose‐response analyses were also performed. A total of 18 studies with 1 356 188 participants were included. The summary RR of stroke for the highest compared with the lowest AHM adherence level was 0.73 (95% CI, 0.67–0.79). Stratified by stroke subtype, a higher AHM adherence was associated with lower risks of ischemic stroke (RR, 0.74; 95% CI, 0.69–0.79) and hemorrhagic stroke (RR, 0.55; 95% CI, 0.42–0.72). Moreover, both fatal (RR, 0.51; 95% CI, 0.36–0.73) and nonfatal stroke (RR, 0.52; 95% CI, 0.28–0.94) were lower in participants with higher AHM adherence. The results of a dose‐response analysis indicated that a 20% increment in AHM adherence level was associated with a 9% lower risk of stroke (RR, 0.91; 95% CI, 0.86–0.96). ConclusionsHigher AHM adherence is dose‐dependently associated with a lower risk of stroke in patients with hypertension. |
| first_indexed | 2024-12-14T07:07:53Z |
| format | Article |
| id | doaj.art-104eb3de84284bce8e48eaea1135f568 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-14T07:07:53Z |
| publishDate | 2017-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-104eb3de84284bce8e48eaea1135f5682022-12-21T23:12:04ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-07-016710.1161/JAHA.117.006371Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐AnalysisTao Xu0Xinyuan Yu1Shu Ou2Xi Liu3Jinxian Yuan4Xinjie Tan5Yangmei Chen6Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaBackgroundInconsistent findings have been obtained for previous studies evaluating the association between antihypertensive medication (AHM) adherence and the risk of stroke. This dose‐response meta‐analysis was designed to investigate the association between AHM adherence and stroke risk. Methods and ResultsMEDLINE and Embase databases were systematically searched to identify relevant studies. The quantification of adherence to AHM was calculated as the percentage of the sum of days with AHM actually taken divided by the total number of days in a specific period. Summary relative risks (RR) and 95% CIs were estimated using a random‐effects model. Stratified and dose‐response analyses were also performed. A total of 18 studies with 1 356 188 participants were included. The summary RR of stroke for the highest compared with the lowest AHM adherence level was 0.73 (95% CI, 0.67–0.79). Stratified by stroke subtype, a higher AHM adherence was associated with lower risks of ischemic stroke (RR, 0.74; 95% CI, 0.69–0.79) and hemorrhagic stroke (RR, 0.55; 95% CI, 0.42–0.72). Moreover, both fatal (RR, 0.51; 95% CI, 0.36–0.73) and nonfatal stroke (RR, 0.52; 95% CI, 0.28–0.94) were lower in participants with higher AHM adherence. The results of a dose‐response analysis indicated that a 20% increment in AHM adherence level was associated with a 9% lower risk of stroke (RR, 0.91; 95% CI, 0.86–0.96). ConclusionsHigher AHM adherence is dose‐dependently associated with a lower risk of stroke in patients with hypertension.https://www.ahajournals.org/doi/10.1161/JAHA.117.006371antihypertensive medicationdose responsemedication adherencemeta‐analysisstroke |
| spellingShingle | Tao Xu Xinyuan Yu Shu Ou Xi Liu Jinxian Yuan Xinjie Tan Yangmei Chen Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease antihypertensive medication dose response medication adherence meta‐analysis stroke |
| title | Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis |
| title_full | Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis |
| title_fullStr | Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis |
| title_full_unstemmed | Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis |
| title_short | Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis |
| title_sort | adherence to antihypertensive medications and stroke risk a dose response meta analysis |
| topic | antihypertensive medication dose response medication adherence meta‐analysis stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.006371 |
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