Self-Reported Medication Adherence and Cardiovascular Events in Patients with Stable Coronary Heart Disease

The Heart and Soul Study

The present article considered cardiovascular patients' adherence to physicians' medication recommendations. Nonadherence was defined as following the suggested medicine regiment 75 percent or less of the time. Study participants were 1,015 outpatients with coronary heart disease (CHD) who took part in the Heart and Soul Study. Participants were asked about adherence and had their medical records evaluated for cardiovascular events such as CHD death, myocardial infarction (MI) and stroke over a period of 3.9 years. Additionally, the risks related to nonadherence by patients with CHD were compared to risks related to diabetes, hypertension and smoking.

Key Findings:

  • Nonadherence was reported by 8.2 percent of study participants. Nonadherent participants were less likely to be white and have attained a high school education then adherent participants, and more likely to be younger and female.
  • During the follow-up time period, 14.4 percent of participants experienced a cardiovascular event.
  • Of adherent study participants, 13.9 percent experienced cardiovascular events compared to 22.9 percent of nonadherent participants.
  • Nonadherent participants encountered cardiovascular events at a relative rate comparable to rates seen with diabetes and smoking.
  • Even when adjusting for standard risk factors such as age and race, symptoms of depression, and more severe CHD at baseline, nonadherence still predicted participant experience of cardiovascular events.

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