Disparities in hypertension and cardiovascular disease in blacks: The critical role of medication adherence.
Disparities in hypertension and cardiovascular disease in blacks: The critical role of medication adherence.
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DOI：
10.1111/jch.13089
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Senatore FF
中科院分区：
文献类型：
--
作者：
Ferdinand KC;Yadav K;Nasser SA;Clayton-Jeter HD;Lewin J;Cryer DR;Senatore FF
黑人死于可预防的心脏病和中风的可能性是白人的两到三倍。心脏病死亡率的下降并没有消除种族差异。高血压是导致心血管疾病的主要原因，在黑人中控制和有效治疗高血压的情况少于白人，这仍然是一个挑战。这种种族/民族差异背后的驱动力之一是药物不依从，其原因植根于社会决定因素。确定了八种解决药物依从性的实用方法，这些方法有可能缩小差异，包括：(1)患者参与策略，(2)消费者导向的医疗保健，(3)患者门户网站，(4)智能应用程序和短信，(5)数字碉堡，(6)药剂师主导的参与，(7)心脏康复，(8)基于认知的行为。然而，虽然数据表明这些策略可以改善药物依从性，但对改善种族/民族差异的影响尚不确定。这篇综述描述了差异和药物依从性之间的关系，这可能在心血管发病率和死亡率的持续差异中起作用。
Blacks are two to three times as likely as whites to die of preventable heart disease and stroke. Declines in mortality from heart disease have not eliminated racial disparities. Control and effective treatment of hypertension, a leading cause of cardiovascular disease, among blacks is less than in whites and remains a challenge. One of the driving forces behind this racial/ethnic disparity is medication nonadherence whose cause is embedded in social determinants. Eight practical approaches to addressing medication adherence with the potential to attenuate disparities were identified and include: (1) patient engagement strategies, (2) consumer-directed health care, (3) patient portals, (4) smart apps and text messages, (5) digital pillboxes, (6) pharmacist-led engagement, (7) cardiac rehabilitation, and (8) cognitive-based behavior. However, while data suggest that these strategies may improve medication adherence, the effect on ameliorating racial/ethnic disparities is not certain. This review describes the relationship between disparities and medication adherence, which likely plays a role in persistent disparities in cardiovascular morbidity and mortality.
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