Pre-stroke Adherence to Hypertension Medications in a Bi-racial United States Stroke Belt

Introduction: Blood pressure is not optimally reduced in 3 of 4 patients with hypertension (HTN) in the United States. Aim: We analyzed for factors associations with premorbid non-adherence to HTN medications in acute stroke patients. Methods: This cross-sectional study included 225 acute stroke patients with self-reported adherence to HTM medications in a stroke registry in the Southeastern United States. We defined medication non-adherence as < 90% of prescribed. Logistic regression analyzed demographic and socioeconomic factors for prediction of adherence. Results: There were 145 (64%) patients with adherence and 80 (36%) with non-adherence. The likelihood of adherence to HTN medications was decreased among black patients, OR 0.49 (95% CI 0.26–0.93), p = 0.03, and those without health insurance, OR 0.29 (95% CI 0.13–0.64), p = 0.002. Specific reasons for non-adherence were high medication cost in 26 (33%), side effects in 8 (10%), and other unspecified reasons in 46 (58%) patients. Conclusion: In this study, adherence to HTN medications was significantly lower among black patients and those without health insurance.