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

Q: How was medication adherence measured in the study?

Medication adherence was assessed using the medication possession ratio. Patients were grouped as good (≥0.8), moderate (0.5–<0.8), and poor (<0.5) adherence.

Q: What were the main clinical outcomes analyzed?

The primary outcomes were overall mortality and cardiovascular mortality. A secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases.

Q: What overall relationship did the study find between nonadherence and outcomes?

Nonadherence to antihypertensive medication was common among patients with cancer and was associated with worse clinical outcomes, including higher mortality and increased cardiovascular event risk.

Sep 28, 2026

Uploaded by Quinn Holloway

Hypertension drives major cardiovascular events and mortality, and adherence to antihypertensive therapy may influence outcomes in adults with cancer. Using the 2002–2013 Korean National Health Insurance Service–National Sample Cohort, researchers categorized 19,246 cancer patients with concomitant hypertension by medication possession ratio into good (≥0.8), moderate (0.5–<0.8), and poor (<0.5) adherence groups. Over 8.4 years, nonadherence was common and linked to higher overall and cardiovascular mortality and more hospitalization-requiring cardiovascular events.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Background

Methods and Results

Adherence grouping and outcomes

Mortality and cardiovascular event findings

Conclusions

Key Words

Journal of the American Heart Association ORIGINAL RESEARCH Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study Mi-Hyang Jung , MD, PhD*; So-Young Lee , MD*; Jong-Chan Youn , MD, PhD; Woo-Baek Chung , MD, PhD; Sang-Hyun Ihm , MD, PhD; Dongwoo Kang , BA; Dae-Sung Kyoung , PhD; Hae Ok Jung , MD, PhD; Kiyuk Chang , MD, PhD; Ho-Joong Youn, MD, PhD; Hokyou Lee , MD, PhD; Danbee Kang , PhD; Juhee Cho , PhD; Hidehiro Kaneko , MD, PhD; Hyeon Chang Kim , MD, PhD 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 extracted 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, respectively, 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. Key Words: adherence ■ cancer ■ cardiovascular disease ■ hypertension ■ survivorship Correspondence to: Jong-Chan Youn, MD, PhD, Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea. Email: [jong.chan.youn@gmail.com](jong.chan.youn@gmail.com) and Hyeon Chang Kim, MD, PhD, Department of Preventive Medicine, Yonsei University College of Medicine, Yonsei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Email: [hckim@yuhs.ac](hckim@yuhs.ac) *M. -H. Jung and S. -Y. Lee contributed equally as co–first authors. This article was sent to Tochukwu M. Okwuosa, DO, Associate Editor, for review by expert referees, editorial decision, and final disposition. Supplemental Material is available at [https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.029362](https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.029362)[ ](https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.029362)[For Sources of Funding and Disclosures](For Sources of Funding and Disclosures) , see page 8. © 2023 The Authors. Published on behalf of the American Heart Association, Inc. , by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use

FAQs

How was medication adherence measured in the study?

Medication adherence was assessed using the medication possession ratio. Patients were grouped as good (≥0.8), moderate (0.5–<0.8), and poor (<0.5) adherence.

What were the main clinical outcomes analyzed?

The primary outcomes were overall mortality and cardiovascular mortality. A secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases.

What overall relationship did the study find between nonadherence and outcomes?

Nonadherence to antihypertensive medication was common among patients with cancer and was associated with worse clinical outcomes, including higher mortality and increased cardiovascular event risk.

Sep 28, 2026

Uploaded by Quinn Holloway