Adherence to Antihypertensive Medication in Post-Stroke Patients: Patterns, Barriers, and Clinical Outcomes in a Prospective Cohort Study

Authors

  • Prateek Nitey
  • Piyush Bhagat
  • Rinkita Sahare
  • Anil Modak
  • Kartik Khurana
  • Diksha Wani

Keywords:

Adherence, Anti-Hypertensive Medicines, Post-Stroke

Abstract

Background: Medication adherence is crucial for secondary stroke prevention, yet non-adherence remains a significant challenge. This study evaluates adherence patterns, identifies key barriers, and assesses clinical outcomes in post-stroke patients receiving antihypertensive therapy.

Methods: A prospective cohort study was conducted in a single tertiary care center, enrolling 150 post-stroke patients. Adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Barriers to adherence were identified through structured questionnaires. Clinical outcomes, including blood pressure control, recurrent stroke, and cardiovascular events, were recorded over a 12-month follow-up. Statistical analyses included Chi-square tests, logistic regression, and Kaplan-Meier survival analysis.

Results: Only 36% of patients exhibited high adherence, while 32% had moderate and 32% had low adherence. Key barriers included forgetfulness (42%), fear of side effects (28%), and cost-related constraints (25%). Patients with low adherence had a 3.2-fold increased risk of recurrent stroke (p = 0.002). Blood pressure control was achieved in 85% of high-adherence patients versus 29% in the low-adherence group (p < 0.001).

Conclusion: Adherence to antihypertensive therapy remains suboptimal in post-stroke patients, contributing to poor clinical outcomes. Targeted interventions addressing barriers to adherence are essential to enhance secondary stroke prevention and improve patient survival

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References

Donkor E. S. (2018). Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke research and treatment, 2018, 3238165. https://doi.org/10.1155/2018/3238165

Funakoshi, S., Kawazoe, M., Tada, K., Abe, M., & Arima, H. (2022). Blood Pressure Lowering for the Secondary Prevention of Stroke. Cardiology Discovery, 2(1), 51–57. https://doi.org/10.1097/cd9.0000000000000048

Hamrahian, S. M., Maarouf, O. H., & Fülöp, T. (2022). A Critical Review of Medication Adherence in Hypertension: Barriers and Facilitators Clinicians Should Consider. Patient preference and adherence, 16, 2749–2757. https://doi.org/10.2147/PPA.S368784

Lee, H. J., Jang, S. I., & Park, E. C. (2017). Effect of adherence to antihypertensive medication on stroke incidence in patients with hypertension: a population-based retrospective cohort study. BMJ open, 7(6), e014486. https://doi.org/10.1136/bmjopen-2016-014486

Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7), 1100. https://doi.org/10.3390/pharmaceutics13071100

Janežič, A., Locatelli, I., & Kos, M. (2017). Criterion validity of 8-item Morisky Medication Adherence Scale in patients with asthma. PloS one, 12(11), e0187835. https://doi.org/10.1371/journal.pone.0187835

Oh S. W. (2021). Medication Adherence and Effective Management of Hypertension. Korean journal of family medicine, 42(2), 89–90. https://doi.org/10.4082/kjfm.42.2E

Souliotis, K., Giannouchos, T. V., Golna, C., & Liberopoulos, E. (2022). Assessing forgetfulness and polypharmacy and their impact on health-related quality of life among patients with hypertension and dyslipidemia in Greece during the COVID-19 pandemic. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 31(1), 193–204. https://doi.org/10.1007/s11136-021-02917-y

Baryakova, T. H., Pogostin, B. H., Langer, R., & McHugh, K. J. (2023). Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nature reviews. Drug discovery, 22(5), 387–409. https://doi.org/10.1038/s41573-023-00670-0

Peng, X., Wan, L., Yu, B. et al. The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies. BMC Cardiovasc Disord 25, 145 (2025). https://doi.org/10.1186/s12872-025-04538-6

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Published

2025-06-11

How to Cite

1.
Nitey P, Bhagat P, Sahare R, Modak A, Khurana K, Wani D. Adherence to Antihypertensive Medication in Post-Stroke Patients: Patterns, Barriers, and Clinical Outcomes in a Prospective Cohort Study. J Neonatal Surg [Internet]. 2025Jun.11 [cited 2025Nov.2];14(31S):802-7. Available from: https://jneonatalsurg.com/index.php/jns/article/view/7271

Issue

Vol. 14 No. 31S (2025): Journal of Neonatal Surgery

Section

Original Article

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