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Racial/ethnic disparities in medication use among veterans with hypertension and dementia: a national cohort study
Poon I, Lal LS, Ford ME, Braun UK.. The Annals of pharmacotherapy, 2009-02-03
Topic: Risk, prevention and care in population studies
Background Hypertension and comorbid dementia are common illnesses affecting older adults disproportionally. Medication adherence is vital in achieving therapeutic outcomes. Use of antihypertensive and dementia medications may vary by race/ethnicity and has not been well explored. Objective To evaluate the utilization of antihypertensive and dementia drugs and adherence in a national cohort of veterans aged 65 years or older with a diagnosis of both hypertension and dementia across different racial/ethnic groups. Methods This was a retrospective cohort study that used 2 national databases of the Veterans Health Administration to estimate medication utilization and adherence rates among whites, African Americans, and Hispanics from 2000 to 2005. A medication possession ratio of 0.8 or greater defined adherence. The association between race/ethnicity and adherence was analyzed using multivariate logistic regression analysis. Results A total of 56,561 patients (70.5% white, 15.6% African American, 6.6% Hispanic) aged 65 years or older had diagnoses of dementia and hypertension. African Americans were less likely than whites to receive angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, acetylcholinesterase inhibitors, and memantine (p Conclusions Racial/ethnic differences exist in antihypertensive and dementia medication use in a cohort of older adults with hypertension and dementia. Adherence rates for a number of antihypertensive and dementia drugs are lower for minorities compared with whites. Healthcare providers should make special efforts to improve medication adherence among minorities.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Poon, I., Lal, L. S., Ford, M. E., & Braun, U. K. (2009). Racial/ethnic disparities in medication use among veterans with hypertension and dementia: a national cohort study. The Annals of pharmacotherapy. https://doi.org/10.1345/aph.1l368
Vancouver
Poon I, Lal LS, Ford ME, Braun UK. Racial/ethnic disparities in medication use among veterans with hypertension and dementia: a national cohort study. The Annals of pharmacotherapy. 2009. doi:10.1345/aph.1l368. PMID: 19193586.
BibTeX
@article{poon2009-19193586,
author = {Poon, I. and Lal, L. S. and Ford, M. E. and Braun, U. K.},
title = {{Racial/ethnic disparities in medication use among veterans with hypertension and dementia: a national cohort study}},
journal = {The Annals of pharmacotherapy},
year = {2009},
doi = {10.1345/aph.1l368},
pmid = {19193586},
url = {https://doi.org/10.1345/aph.1l368}
}
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Key findings
- Results A total of 56,561 patients (70.5% white, 15.6% African American, 6.6% Hispanic) aged 65 years or older had diagnoses of dementia and hypertension.
- Adherence rates for a number of antihypertensive and dementia drugs are lower for minorities compared with whites.
Why it matters
Among veterans with both hypertension and dementia, African Americans were less likely than whites to receive certain antihypertensive and dementia medications, and adherence rates for a number of these drugs were lower for minorities compared with whites. This describes disparities in medication use, not whether any treatment cures or prevents dementia.
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Study details
- Study designcohort study
- Participants56,561
- Effect size70.5%; 15.6%; 6.6%
- Evidence strengthModerate
How this study scored 59/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Annals of pharmacotherapy) |
| Journal's citation record | 2 / 4 | Annals of Pharmacotherapy: journal h-index 153 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 56,561 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 90 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.7 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 4.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Ursula K. Braun: h-index 20 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Baylor College of Medicine: institution h-index 1,607 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19193586) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
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