Self-Rated Cardiac Risk Linked to Cardiovascular Mortality

Pilot study demonstrates value of integrated care intervention for depression, hypertension

TUESDAY, July 15 (HealthDay News) -- Cardiovascular mortality is lower in men -- but not in women -- who rate themselves as having a lower-than-average cardiovascular risk. Also, an integrated care intervention may improve medication adherence in older adults who are on antihypertensive and antidepressant therapy, according to two studies published in the July/August issue of the Annals of Family Medicine.

In one study, Robert Gramling, M.D., of Memorial Hospital of Rhode Island in Pawtucket, R.I., and colleagues conducted a 15-year mortality surveillance study of 2,816 adults aged 35 to 75. They found that rates of cardiovascular disease mortality were significantly lower in men who rated themselves as having a lower-than-average risk (hazard ratio, 0.3) but not in women (HR, 0.9).

In a second study, Hillary R. Bogner, M.D., of the University of Pennsylvania in Philadelphia, and a colleague randomly assigned 64 subjects aged 50 to 80 who were prescribed medication for depression and hypertension to either an integrated care intervention or usual care. They found that the intervention group was significantly more likely than the usual care group to be adherent to antidepressant medication (71.9 percent versus 31.3 percent) and antihypertensive medication (78.1 percent versus 31.3 percent).

"Further research is needed to evaluate this intervention in a larger, more representative sample with longer periods of follow-up," Bogner and colleagues conclude. "Future investigations could explore the training of ancillary health personnel who are already working in primary care practices to carry out the intervention."

Abstract - Gramling
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Abstract - Bogner
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