Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study

Mi Hyang Jung; So Young Lee; Jong Chan Youn; Woo Baek Chung; Sang Hyun Ihm; Dongwoo Kang; Dae Sung Kyoung; Hae Ok Jung; Kiyuk Chang; Ho Joong Youn; Hokyou Lee; Danbee Kang; Juhee Cho; Hidehiro Kaneko; Hyeon Chang Kim

doi:10.1161/JAHA.123.029362

Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study

Mi Hyang Jung, So Young Lee, Jong Chan Youn, Woo Baek Chung, Sang Hyun Ihm, Dongwoo Kang, Dae Sung Kyoung, Hae Ok Jung, Kiyuk Chang, Ho Joong Youn, Hokyou Lee, Danbee Kang, Juhee Cho, Hidehiro Kaneko, Hyeon Chang Kim

Division of Cardiology

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

BACKGROUND: Hypertension is an important cause of morbidity, which predisposes patients to major cardiovascular events and mortality. The aim of this study was to explore the association between adherence to antihypertensive medication and clinical outcomes in adult patients with cancer. METHODS AND RESULTS: Using the 2002 to 2013 Korean National Health Insurance Service– National Sample Cohort, we ex-tracted adult patients with cancer treated with antihypertensive medications. Based on the medication possession ratio value, participants were divided into 3 groups: good (medication possession ratio ≥0.8), moderate (0.5≤ medication possession ratio <0.8), and poor (medication possession ratio <0.5) adherence groups. The primary outcomes were overall and cardiovascular mortality. The secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases. Among 19 246 patients with cancer with concomitant hypertension, 66.4% were in the nonadherence group (26.3% were moderate and 40.0% were poor adherence group). Over a median of 8.4 years of follow-up, 2752 deaths and 6057 cardiovascular events occurred. Compared with the good adherence group, the moderate and poor adherence groups had a 1.85-fold and 2.19-fold increased risk for overall mortality, and 1.72-fold and 1.71-fold elevated risk for cardiovascular mortality, respec-tively, after adjustment for possible confounders. Furthermore, the moderate and poor adherence groups had a 1.33-fold and 1.34-fold elevated risk of new-onset cardiovascular events, respectively. These trends were consistent across cardiovascular event subtypes. CONCLUSIONS: Nonadherence to antihypertensive medication was common in patients with cancer and was associated with worse clinical outcomes in adult patients with cancer with hypertension. More attention should be paid to improving adherence to antihypertensive medication among patients with cancer.

Original language	English
Article number	e029362
Journal	Journal of the American Heart Association
Volume	12
Issue number	14
DOIs	https://doi.org/10.1161/JAHA.123.029362
State	Published - 2023

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea grant funded by the Ministry of Science and Information and Communication Technologies (NRF-2021R1F1A1063430), by the Catholic Medical Center Research Foundation (2022), by the Research Foundation of Internal Medicine, The Catholic University of Korea, by the Korean Society of Cardiovascular Disease Prevention, and by a grant of the Korea Health

Funding Information:
Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI19C1211). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.

Publisher Copyright:
© 2023 The Authors.

Keywords

adherence
cancer
cardiovascular disease
hypertension
survivorship

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1161/JAHA.123.029362

Cite this

Jung, M. H., Lee, S. Y., Youn, J. C., Chung, W. B., Ihm, S. H., Kang, D., Kyoung, D. S., Jung, H. O., Chang, K., Youn, H. J., Lee, H., Kang, D., Cho, J., Kaneko, H., & Kim, H. C. (2023). Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study. Journal of the American Heart Association, 12(14), Article e029362. https://doi.org/10.1161/JAHA.123.029362

@article{be5b9f26f09f48499a5fcd65bbdd1373,

title = "Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study",

abstract = "BACKGROUND: Hypertension is an important cause of morbidity, which predisposes patients to major cardiovascular events and mortality. The aim of this study was to explore the association between adherence to antihypertensive medication and clinical outcomes in adult patients with cancer. METHODS AND RESULTS: Using the 2002 to 2013 Korean National Health Insurance Service– National Sample Cohort, we ex-tracted adult patients with cancer treated with antihypertensive medications. Based on the medication possession ratio value, participants were divided into 3 groups: good (medication possession ratio ≥0.8), moderate (0.5≤ medication possession ratio <0.8), and poor (medication possession ratio <0.5) adherence groups. The primary outcomes were overall and cardiovascular mortality. The secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases. Among 19 246 patients with cancer with concomitant hypertension, 66.4% were in the nonadherence group (26.3% were moderate and 40.0% were poor adherence group). Over a median of 8.4 years of follow-up, 2752 deaths and 6057 cardiovascular events occurred. Compared with the good adherence group, the moderate and poor adherence groups had a 1.85-fold and 2.19-fold increased risk for overall mortality, and 1.72-fold and 1.71-fold elevated risk for cardiovascular mortality, respec-tively, after adjustment for possible confounders. Furthermore, the moderate and poor adherence groups had a 1.33-fold and 1.34-fold elevated risk of new-onset cardiovascular events, respectively. These trends were consistent across cardiovascular event subtypes. CONCLUSIONS: Nonadherence to antihypertensive medication was common in patients with cancer and was associated with worse clinical outcomes in adult patients with cancer with hypertension. More attention should be paid to improving adherence to antihypertensive medication among patients with cancer.",

keywords = "adherence, cancer, cardiovascular disease, hypertension, survivorship",

author = "Jung, {Mi Hyang} and Lee, {So Young} and Youn, {Jong Chan} and Chung, {Woo Baek} and Ihm, {Sang Hyun} and Dongwoo Kang and Kyoung, {Dae Sung} and Jung, {Hae Ok} and Kiyuk Chang and Youn, {Ho Joong} and Hokyou Lee and Danbee Kang and Juhee Cho and Hidehiro Kaneko and Kim, {Hyeon Chang}",

note = "Funding Information: This work was supported by the National Research Foundation of Korea grant funded by the Ministry of Science and Information and Communication Technologies (NRF-2021R1F1A1063430), by the Catholic Medical Center Research Foundation (2022), by the Research Foundation of Internal Medicine, The Catholic University of Korea, by the Korean Society of Cardiovascular Disease Prevention, and by a grant of the Korea Health Funding Information: Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI19C1211). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. Publisher Copyright: {\textcopyright} 2023 The Authors.",

year = "2023",

doi = "10.1161/JAHA.123.029362",

language = "English",

volume = "12",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "14",

}

Jung, MH, Lee, SY, Youn, JC, Chung, WB, Ihm, SH, Kang, D, Kyoung, DS, Jung, HO , Chang, K , Youn, HJ, Lee, H, Kang, D, Cho, J, Kaneko, H & Kim, HC 2023, 'Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study', Journal of the American Heart Association, vol. 12, no. 14, e029362. https://doi.org/10.1161/JAHA.123.029362

TY - JOUR

T1 - Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer

T2 - A Nationwide Population-Based Cohort Study

AU - Jung, Mi Hyang

AU - Lee, So Young

AU - Youn, Jong Chan

AU - Chung, Woo Baek

AU - Ihm, Sang Hyun

AU - Kang, Dongwoo

AU - Kyoung, Dae Sung

AU - Jung, Hae Ok

AU - Chang, Kiyuk

AU - Youn, Ho Joong

AU - Lee, Hokyou

AU - Kang, Danbee

AU - Cho, Juhee

AU - Kaneko, Hidehiro

AU - Kim, Hyeon Chang

N1 - Funding Information: This work was supported by the National Research Foundation of Korea grant funded by the Ministry of Science and Information and Communication Technologies (NRF-2021R1F1A1063430), by the Catholic Medical Center Research Foundation (2022), by the Research Foundation of Internal Medicine, The Catholic University of Korea, by the Korean Society of Cardiovascular Disease Prevention, and by a grant of the Korea Health Funding Information: Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI19C1211). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. Publisher Copyright: © 2023 The Authors.

PY - 2023

Y1 - 2023

N2 - BACKGROUND: Hypertension is an important cause of morbidity, which predisposes patients to major cardiovascular events and mortality. The aim of this study was to explore the association between adherence to antihypertensive medication and clinical outcomes in adult patients with cancer. METHODS AND RESULTS: Using the 2002 to 2013 Korean National Health Insurance Service– National Sample Cohort, we ex-tracted adult patients with cancer treated with antihypertensive medications. Based on the medication possession ratio value, participants were divided into 3 groups: good (medication possession ratio ≥0.8), moderate (0.5≤ medication possession ratio <0.8), and poor (medication possession ratio <0.5) adherence groups. The primary outcomes were overall and cardiovascular mortality. The secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases. Among 19 246 patients with cancer with concomitant hypertension, 66.4% were in the nonadherence group (26.3% were moderate and 40.0% were poor adherence group). Over a median of 8.4 years of follow-up, 2752 deaths and 6057 cardiovascular events occurred. Compared with the good adherence group, the moderate and poor adherence groups had a 1.85-fold and 2.19-fold increased risk for overall mortality, and 1.72-fold and 1.71-fold elevated risk for cardiovascular mortality, respec-tively, after adjustment for possible confounders. Furthermore, the moderate and poor adherence groups had a 1.33-fold and 1.34-fold elevated risk of new-onset cardiovascular events, respectively. These trends were consistent across cardiovascular event subtypes. CONCLUSIONS: Nonadherence to antihypertensive medication was common in patients with cancer and was associated with worse clinical outcomes in adult patients with cancer with hypertension. More attention should be paid to improving adherence to antihypertensive medication among patients with cancer.

AB - BACKGROUND: Hypertension is an important cause of morbidity, which predisposes patients to major cardiovascular events and mortality. The aim of this study was to explore the association between adherence to antihypertensive medication and clinical outcomes in adult patients with cancer. METHODS AND RESULTS: Using the 2002 to 2013 Korean National Health Insurance Service– National Sample Cohort, we ex-tracted adult patients with cancer treated with antihypertensive medications. Based on the medication possession ratio value, participants were divided into 3 groups: good (medication possession ratio ≥0.8), moderate (0.5≤ medication possession ratio <0.8), and poor (medication possession ratio <0.5) adherence groups. The primary outcomes were overall and cardiovascular mortality. The secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases. Among 19 246 patients with cancer with concomitant hypertension, 66.4% were in the nonadherence group (26.3% were moderate and 40.0% were poor adherence group). Over a median of 8.4 years of follow-up, 2752 deaths and 6057 cardiovascular events occurred. Compared with the good adherence group, the moderate and poor adherence groups had a 1.85-fold and 2.19-fold increased risk for overall mortality, and 1.72-fold and 1.71-fold elevated risk for cardiovascular mortality, respec-tively, after adjustment for possible confounders. Furthermore, the moderate and poor adherence groups had a 1.33-fold and 1.34-fold elevated risk of new-onset cardiovascular events, respectively. These trends were consistent across cardiovascular event subtypes. CONCLUSIONS: Nonadherence to antihypertensive medication was common in patients with cancer and was associated with worse clinical outcomes in adult patients with cancer with hypertension. More attention should be paid to improving adherence to antihypertensive medication among patients with cancer.

KW - adherence

KW - cancer

KW - cardiovascular disease

KW - hypertension

KW - survivorship

UR - http://www.scopus.com/inward/record.url?scp=85165221272&partnerID=8YFLogxK

U2 - 10.1161/JAHA.123.029362

DO - 10.1161/JAHA.123.029362

M3 - Article

C2 - 37421285

AN - SCOPUS:85165221272

SN - 2047-9980

VL - 12

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 14

M1 - e029362

ER -

Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this