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Research Letter |

Posttraumatic Stress Disorder and Medication Nonadherence in Patients With Uncontrolled Hypertension

Ian M. Kronish, MD, MPH1; Jenny J. Lin, MD, MPH2; Beth E. Cohen, MD, MAS3,4; Corrine I. Voils, PhD5,6; Donald Edmondson, PhD1
[+] Author Affiliations
1Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York
2Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
3General Internal Medicine, Department of Veterans Affairs Medical Center, San Francisco, California
4Department of Medicine, University of California, San Francisco, California
5Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina
6Department of Medicine, Duke University Medical Center, Durham, North Carolina
JAMA Intern Med. 2014;174(3):468-470. doi:10.1001/jamainternmed.2013.12881.
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Posttraumatic stress disorder (PTSD) is common in primary care patients1 and is associated with psychological distress, suicide risk, and disability. Posttraumatic stress disorder also increases risk of incident and recurrent cardiovascular events,2 possibly by reducing medication adherence.3 Prior studies showing an association between PTSD and medication nonadherence3 are limited by their use of self-report to measure adherence as PTSD can bias reporting of negative behaviors.4 We evaluated the association between PTSD and antihypertensive medication adherence using electronic monitoring in primary care patients with uncontrolled hypertension.

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Posttraumatic Stress Disorder (PTSD) Symptoms and Nonadherence to Antihypertensive Medications

Nonadherence was defined as taking less than 80% of the antihypertensive regimen. Error bars represent 95% CIs.

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