Medication Adherence in Veterans with Hypertension: Study Reveals Challenges and Implications for Future Treatment

Strategic Insights -

Research conducted at the Veterans Affairs Medical Center in Boston, Massachusetts, has shed light on the importance of medication adherence in preventing major adverse cardiovascular events in older hypertensive patients. The study, published in the Journal of Clinical Medicine, analyzed data from a large pragmatic trial comparing two thiazide diuretics, chlorthalidone (CTD) and hydrochlorothiazide (HCTZ), and found that nearly 30% of participants were categorized as non-adherent to their medication.

Key Takeaways:

  • The study involved 13,523 older hypertensive patients randomized from 72 Veterans Affairs medical centers, with a median medication possession ratio (MPR) of 95% for all randomized patients and 80% for those who reached 2.4 years of follow-up.
  • Lower MPR was observed in Black, separated, urban-living, and comorbid patients, highlighting the need for personalized treatment approaches.
  • The research emphasizes the importance of adherence to antihypertensive treatment in preventing major adverse cardiovascular events, particularly among vulnerable populations.
  • The study's findings have implications for future treatment strategies, given the expected growth in hypertension and the older adult population.
  • The Diuretic Comparison Project highlighted the challenges of suboptimal adherence and the need for more effective treatment approaches.
  • The study's authors include Cynthia Hau, Cooperative Studies Program Coordinating Center, Veterans Affairs Medical Center, Boston, MA 02111, United States, and Colleen A. Hynes, Patricia Woods, Sarah Leatherman, Sonia T. Anand, Peter Glassman, Addison Taylor, William C. Cushman, Areef Ishani, and Ryan Ferguson.

Statistics:

  • 13,523 older hypertensive patients were randomized from 72 Veterans Affairs medical centers.
  • The median medication possession ratio (MPR) was 95% for all randomized patients and 80% for those who reached 2.4 years of follow-up.
  • 30% of participants (n = 4022) were categorized as non-adherent to their medication.
  • The study's findings have significant implications for future treatment strategies, given the expected growth in hypertension and the older adult population.

Sources:

  • "Medication Adherence in the Real World: Lessons from the Diuretic Comparison Project." Journal of Clinical Medicine 14(16).
  • NewsRx. "Findings from Veterans Affairs Medical Center Broaden Understanding of Veterans (Medication Adherence in the Real World: Lessons from the Diuretic Comparison Project)." Hematology Week. September 15, 2025; p 60.