Adherence Trajectories to Hypertension Treatment Among Older Individuals: Association with Depression and Anxiety?

Background: Effective hypertension management depends partly on medication adherence. Mental health disorders, such as anxiety and depression, may influence adherence, but evidence in older populations is limited. This secondary analysis of a cohort study identifies adherence trajectories to antihypertensive medications among older adults and assesses whether anxiety and depression are associated with trajectory membership. Patients and Methods: A cohort of 986 older adults (aged 65 and above) using antihypertensive treatments was analyzed. Adherence was measured using prescription claims over a 12-month period. Adherence patterns over time were characterized using Group-Based Trajectory Modeling (GBTM). Self-reported symptoms and diagnostic codes for anxiety and depression were used to assess for mental health disorders. Associations between depression or anxiety and adherence trajectories were investigated using logistic regression models adjusting for potential confounders. Results: We identified two stable adherence trajectories: a high-adherence group (83.6%) and a low-adherence group (16.4%). No evidence of an association was observed between the presence of anxiety (adjusted odds ratio (OR) of 1.2, 95% confidence interval (CI): 0.8–1.9) or depression (adjusted OR of 1.0, 95% CI: 0.6–1.6) and adherence trajectories. Conclusions: While most older adults in the study maintained high adherence to antihypertensive medications, a notable minority consistently demonstrated low adherence. These findings suggest that additional determinants of adherence trajectory, beyond mental health, should be investigated.