Do Patient Concerns About Antihypertensive Use For Dementia Prevention Vary By Current Use Of Antihypertensive?

Woojung Lee,1 Shelly L Gray,1 Douglas Barthold,1 Paul K Crane,2 Eric B Larson,3 Zachary A Marcum1 1School of Pharmacy, University of Washington, Seattle, WA 98195, USA; 2School of Medicine, University of Washington, Seattle, WA 98104, USA; 3Kaiser Permanente Washington Health Research Institute, Sea...

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Bibliographic Details
Main Authors: Lee W, Gray SL, Barthold D, Crane PK, Larson EB, Marcum ZA
Format: Article
Language:English
Published: Dove Medical Press 2019-10-01
Series:Patient Preference and Adherence
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Online Access:https://www.dovepress.com/do-patient-concerns-about-antihypertensive-use-for-dementia-prevention-peer-reviewed-article-PPA
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Summary:Woojung Lee,1 Shelly L Gray,1 Douglas Barthold,1 Paul K Crane,2 Eric B Larson,3 Zachary A Marcum1 1School of Pharmacy, University of Washington, Seattle, WA 98195, USA; 2School of Medicine, University of Washington, Seattle, WA 98104, USA; 3Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USACorrespondence: Zachary A MarcumDepartment of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific St, Box 357630, Seattle, WA 98102, USATel +1 206-685-2559Fax +1 206-543-3835Email zmarcum@uw.edu Twitter @zacharyamarcumPurpose: Antihypertensives may have effects on the brain beyond blood pressure lowering. Ongoing clinical trials aim to evaluate the effectiveness of approved antihypertensives in preventing dementia, including patients with and without hypertension. In order for a dementia prevention strategy using antihypertensives to be effective, it is critical to understand patient concerns about this strategy in both users and non-users of antihypertensives. Thus, this study examined the association between current use of antihypertensive and having concerns about using an antihypertensive as a dementia prevention strategy, as well as sociodemographic factors associated with concerns.Patients and methods: Cross-sectional,  self-administered, web-based survey was conducted among 1661 patients in a large health system in January 2018. Participants reported whether they were currently taking an antihypertensive (yes/no), and what types of hypothetical concerns they have about the idea of taking an antihypertensive to prevent dementia (yes/no, for each of 7 concerns). Associations between the two variables were assessed via logistic regression, and odds ratios with 95% confidence intervals were calculated.Results: Most respondents were female (77%), 51–70 years of age (64%), and white (89%), with 30% reporting current antihypertensive use. Compared to current users, non-users were more likely to report the five following concerns: side effects from the medication, hassle to take medications, lack of evidence, not wanting to use medications, and already having normal/low blood pressure. Non-users were also less likely to report having no concerns (adjusted OR = 0.3; 95% CI = 0.2–0.4) compared to current users. Younger age and lower income were associated with having more concerns.Conclusion: Patients not currently using an antihypertensive are more likely to have concerns about using an antihypertensive for dementia prevention, compared to current antihypertensive users. Patient perspectives are important to consider for the implementation of dementia prevention strategies.Keywords: dementia, antihypertensives, primary prevention, patient concerns, patient perspectives
ISSN:1177-889X