White matter hyperintensities and medication adherence.
White matter hyperintensities and medication adherence.
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DOI：
10.1177/1099800408322216
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发表时间：
2008-10
影响因子：
2.5
通讯作者：
Hsiao CP
中科院分区：
文献类型：
--
作者：
Insel KC;Reminger SL;Hsiao CP
白质高信号(WMH)与高血压、年龄和认知功能有关，但WMH与药物依从性之间的关系尚未被研究。这项调查的目的是考虑高血压相关的脑形态变化对药物依从性的潜在影响，从而提高对高血压自我管理后果的理解。在16名自我管理至少一种处方抗高血压药物的中老年人中，研究了WMH、血压、年龄、认知功能(特别是前额叶功能的评估)和药物依从性之间的关系。使用轴向液体衰减反转恢复(FLAIR)序列的磁共振成像被用来评估WMH的存在。认知评估包括执行功能、工作记忆、注意力和即刻回忆的测量。使用电子药物监测对依从性进行8周的监测。WMH越多，依从性越差(rS=−.25)，收缩压越高(rS=0.46)，尽管这些关系在统计学上没有显著意义。WMH与预期方向的认知评估有关，包括数字向后广度(rS=−.53，p<；0.05)。坚持与即刻记忆相关(rS=.54，p<；0.05)，与未能在威斯康星卡分类测试中保持集合成反比(wcst；rs=−.61，p<；0.05)。这些发现为WMH、前额叶功能评估和药物依从性之间的关联提供了初步证据。
White matter hyperintensities (WMH) are associated with hypertension, age, and cognitive function, but the association between WMH and medication adherence has not been examined. The intent of this investigation was to consider the potential implications of hypertension-related brain morphological changes on medication adherence and thereby improve understanding of the self-management consequences of hypertension. The associations between WMH, blood pressure, age, cognitive function (specifically assessments of prefrontal function), and medication adherence were examined in 16 middle-aged and older adults self-managing at least one prescribed antihypertensive agent. Magnetic resonance imaging using an axial fluid attenuated inversion recovery (FLAIR) sequence was used to assess the presence of WMH. Cognitive assessments included measures of executive function, working memory, attention, and immediate recall. Adherence was monitored for 8 weeks using electronic medication monitoring. More WMH were associated with poorer adherence (rs = −.25) and with higher systolic blood pressure (rs = .46), although these relationships were not statistically significant. WMH were associated with cognitive assessments in the expected direction including Digit Span Backward (rs = −.53, p < .05). Adherence was associated with immediate memory (rs = .54, p < .05) and inversely associated with failure to maintain set on the Wisconsin Card Sorting Test (WCST; rs = −.61, p < .05). These findings provide preliminary evidence for the association between WMH, assessments of prefrontal function, and medication adherence.