Racial differences in adherence to cardiac medications

J Natl Med Assoc. 2003 Jan;95(1):17-27.


Objective: To determine whether there are racial differences in adherence to cardiac medications.

Design: Retrospective analysis.

Patients: African-American and white male veterans aged 45 years or older who had received any of four groups of drugs: angiotensin-converting enzyme inhibitors (ACEIs), beta-blockers (BBs), calcium channel blockers (CCBs,) or HMG CoA (hydroxymethyl glutaryl coenzyme A) reductase inhibitors (statins).

Data: Administrative records were used to identify eligible veterans and their demographic characteristics, medical diagnoses, and medication use. We used a standard measure of adherence to medications based on whether the veteran obtained enough drug to take it as prescribed on 80% of the days.

Results: We identified 833 eligible African-American and 4436 eligible white veterans. In univariable analysis, African Americans were less likely to be adherent to medications than whites for ACEIs (81.4% versus 87.6%, P = 0.004), CCBs (75.3% versus 81.7%, P = 0.003), and statins (59.9% versus 74.1%, P < 0.001) but not BBs (84.8% versus 83.5%, P = 0.6). In multivariable analysis, racial differences in adherence to medications were found primarily among veterans younger than 55 years old.

Conclusions: Younger African Americans were less adherent to medications than whites in a setting where financial barriers are minimized. Although the reason for this finding is unclear, it may contribute to high cardiovascular morbidity among African Americans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • African Americans*
  • Age Factors
  • Aged
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / ethnology*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Retrospective Studies
  • United States / epidemiology
  • Whites*


  • Cardiovascular Agents