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The Impact of Antihypertensive Drugs on Adherence

  • Ian M. Kronish
  • Nathalie Moise
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

There are significant differences in the properties of individual antihypertensive medications in terms of side effects, costs, and dosing complexity among other factors. Accordingly, there are differences in how individual antihypertensive medications impact medication adherence. In this chapter, we review the literature establishing an association between antihypertensive drug class and medication adherence, with adherence typically highest for angiotensin converting enzyme inhibitors and angiotensin receptor blockers and lowest for diuretics and beta-blockers. We also review the mechanisms through which properties of the principal classes of antihypertensive drugs can influence medication adherence. There is also evidence of substantial differences in how antihypertensive medications affect individual patients, with some medications resulting in greater blood pressure reduction and others in lower tolerability. We discuss how this heterogeneity of treatment effect may lead to differential impacts of antihypertensive drugs on medication adherence among individual patients. We conclude by suggesting approaches to preventing adverse effects of antihypertensive drugs on medication adherence in clinical practice. From a clinician’s perspective, we emphasize personalized, patient-centered approaches, including N-of-1 trials, for optimizing the selection and maintenance of medications with the best opportunity for long-term adherence.

Keywords

Antihypertensives Medication adherence Side effects Drug class Physician communication N-of-1 

Notes

Acknowledgment

Conflicts of Interest: None.

References

  1. 1.
    Moser M. Historical perspectives on the management of hypertension. J Clin Hypertens. 2006;8(8 Suppl 2):15–20; quiz 39.CrossRefGoogle Scholar
  2. 2.
    Allen EV. Sympathectomy for essential hypertension. Circulation. 1952;6(1):131–40.CrossRefPubMedGoogle Scholar
  3. 3.
    Lobay D. Rauwolfia in the treatment of hypertension. Integr Med (Encinitas). 2015;14(3):40–6.Google Scholar
  4. 4.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMedGoogle Scholar
  5. 5.
    Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.CrossRefPubMedGoogle Scholar
  6. 6.
    Chapman RH, Benner JS, Petrilla AA, Tierce JC, Collins SR, Battleman DS, et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med. 2005;165(10):1147–52.CrossRefPubMedGoogle Scholar
  7. 7.
    World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.Google Scholar
  8. 8.
    Chowdhury R, Khan H, Heydon E, Shroufi A, Fahimi S, Moore C, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013;34(38):2940–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Caro JJ, Salas M, Speckman JL, Raggio G, Jackson JD. Persistence with treatment for hypertension in actual practice. CMAJ: Can Med Assoc J. 1999;160(1):31–7.Google Scholar
  10. 10.
    Steiner JF, Earnest MA. The language of medication-taking. Ann Intern Med. 2000;132(11):926–30.CrossRefPubMedGoogle Scholar
  11. 11.
    Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691–705.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Dharmarajan TS, Dharmarajan L. Tolerability of antihypertensive medications in older adults. Drugs Aging. 2015;32(10):773–96.CrossRefPubMedGoogle Scholar
  13. 13.
    Nebeker JR, Barach P, Samore MH. Clarifying adverse drug events: a clinician’s guide to terminology, documentation, and reporting. Ann Intern Med. 2004;140(10):795–801.CrossRefPubMedGoogle Scholar
  14. 14.
    Bardage C, Isacson DG. Self-reported side-effects of antihypertensive drugs: an epidemiological study on prevalence and impact on health-state utility. Blood Press. 2000;9(6):328–34.CrossRefPubMedGoogle Scholar
  15. 15.
    Morgado M, Rolo S, Macedo AF, Pereira L, Castelo-Branco M. Predictors of uncontrolled hypertension and antihypertensive medication nonadherence. J Cardiovasc Dis Res. 2010;1(4):196–202.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Tedla YG, Bautista LE. Drug side effect symptoms and adherence to antihypertensive medication. Am J Hypertens. 2016;29(6):772–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Eaddy MT, Cook CL, O’Day K, Burch SP, Cantrell CR. How patient cost-sharing trends affect adherence and outcomes: a literature review. P T. 2012;37(1):45–55.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Steinman MA, Sands LP, Covinsky KE. Self-restriction of medications due to cost in seniors without prescription coverage. J Gen Intern Med. 2001;16(12):793–9.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Maciejewski ML, Farley JF, Parker J, Wansink D. Copayment reductions generate greater medication adherence in targeted patients. Health Aff. 2010;29(11):2002–8.CrossRefGoogle Scholar
  20. 20.
    Iskedjian M, Einarson TR, MacKeigan LD, Shear N, Addis A, Mittmann N, et al. Relationship between daily dose frequency and adherence to antihypertensive pharmacotherapy: evidence from a meta-analysis. Clin Ther. 2002;24(2):302–16.CrossRefPubMedGoogle Scholar
  21. 21.
    Kesselheim AS, Bykov K, Avorn J, Tong A, Doherty M, Choudhry NK. Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies. Ann Intern Med. 2014;161(2):96–103.CrossRefPubMedGoogle Scholar
  22. 22.
    Kesselheim AS, Misono AS, Shrank WH, Greene JA, Doherty M, Avorn J, et al. Variations in pill appearance of antiepileptic drugs and the risk of nonadherence. JAMA Intern Med. 2013;173(3):202–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Lumbreras B, Lopez-Pintor E. Impact of changes in pill appearance in the adherence to angiotensin receptor blockers and in the blood pressure levels: a retrospective cohort study. BMJ Open. 2017;7(3):e012586.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Marshall IJ, Wolfe CDA, McKevitt C. Lay perspectives on hypertension and drug adherence: systematic review of qualitative research. BMJ: Br Med J. 2012;345:e3953.CrossRefGoogle Scholar
  25. 25.
    Kronish IM, Leventhal H, Horowitz CR. Understanding minority patients’ beliefs about hypertension to reduce gaps in communication between patients and clinicians. J Clin Hypertens. 2012;14(1):38–44.CrossRefGoogle Scholar
  26. 26.
    Shrank WH, Cox ER, Fischer MA, Mehta J, Choudhry NK. Patients’ perceptions of generic medications: although most Americans appreciate the cost-saving value of generics, few are eager to use generics themselves. Health Aff (Project Hope). 2009;28(2):546–56.CrossRefGoogle Scholar
  27. 27.
    Corrao G, Soranna D, La Vecchia C, Catapano A, Agabiti-Rosei E, Gensini G, et al. Medication persistence and the use of generic and brand-name blood pressure-lowering agents. J Hypertens. 2014;32(5):1146–53; discussion 53.CrossRefPubMedGoogle Scholar
  28. 28.
    Ude M, Schuessel K, Quinzler R, Leuner K, Muller WE, Schulz M. Generic switch after ramipril patent expiry is not associated with decreased pharmacy refill compliance: a retrospective study using the DAPI database. J Hypertens. 2011;29(9):1837–45.CrossRefPubMedGoogle Scholar
  29. 29.
    Bramley TJ, Gerbino PP, Nightengale BS, Frech-Tamas F. Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations. J Manag Care Pharm. 2006;12(3):239–45.PubMedGoogle Scholar
  30. 30.
    Ho PM, Magid DJ, Shetterly SM, Olson KL, Peterson PN, Masoudi FA, et al. Importance of therapy intensification and medication nonadherence for blood pressure control in patients with coronary disease. Arch Intern Med. 2008;168(3):271–6.CrossRefPubMedGoogle Scholar
  31. 31.
    DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200–9.CrossRefPubMedGoogle Scholar
  32. 32.
    James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20.CrossRefPubMedGoogle Scholar
  33. 33.
    Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community. J Clin Hypertens. 2014;16(1):14–26.CrossRefGoogle Scholar
  34. 34.
    Task Force for the management of arterial hypertension of the European Society of Hypertension, Task Force for the management of arterial hypertension of the European Society of Cardiology. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Blood Press. 2013;22(4):193–278.Google Scholar
  35. 35.
    Duarte JD, Cooper-DeHoff RM. Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics. Expert Rev Cardiovasc Ther. 2010;8(6):793–802.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981–97.CrossRefGoogle Scholar
  37. 37.
    Osterberg LG, Urquhart J, Blaschke TF. Understanding forgiveness: minding and mining the gaps between pharmacokinetics and therapeutics. Clin Pharmacol Ther. 2010;88(4):457–9.CrossRefPubMedGoogle Scholar
  38. 38.
    Alderman MH, Piller LB, Ford CE, Probstfield JL, Oparil S, Cushman WC, et al. Clinical significance of incident hypokalemia and hyperkalemia in treated hypertensive patients in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Hypertension. 2012;59(5):926–33.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Dhalla IA, Gomes T, Yao Z, Nagge J, Persaud N, Hellings C, et al. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults: a population-based cohort study. Ann Intern Med. 2013;158(6):447–55.CrossRefPubMedGoogle Scholar
  40. 40.
    Makam AN, Boscardin WJ, Miao Y, Steinman MA. Risk of thiazide-induced metabolic adverse events in older adults. J Am Geriatr Soc. 2014;62(6):1039–45.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Haria M, Wagstaff AJ. Amlodipine. A reappraisal of its pharmacological properties and therapeutic use in cardiovascular disease. Drugs. 1995;50(3):560–86.CrossRefPubMedGoogle Scholar
  42. 42.
    Yusuf S. Clinical, public health, and research implications of the Heart Outcomes Prevention Evaluation (HOPE) Study. Eur Heart J. 2001;22(2):103–4.CrossRefPubMedGoogle Scholar
  43. 43.
    Overlack A. ACE inhibitor-induced cough and bronchospasm. Drug Saf. 1996;15(1):72–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Kaufman MB. ACE inhibitor-related angioedema: are your patients at risk? Pharm Ther. 2013;38(3):170–2.Google Scholar
  45. 45.
    Baram M, Kommuri A, Sellers SA, Cohn JR. ACE inhibitor-induced angioedema. J Allergy Clin Immunol Pract. 2013;1(5):442–5.CrossRefPubMedGoogle Scholar
  46. 46.
    Gregoire JP, Moisan J, Guibert R, Ciampi A, Milot A, Cote I, et al. Tolerability of antihypertensive drugs in a community-based setting. Clin Ther. 2001;23(5):715–26.CrossRefPubMedGoogle Scholar
  47. 47.
    Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet. 2004;364(9446):1684–9.CrossRefPubMedGoogle Scholar
  48. 48.
    Ripley TL, Saseen JJ. β-blockers. Ann Pharmacother. 2014;48(6):723–33.CrossRefPubMedGoogle Scholar
  49. 49.
    Van Bortel LM, Fici F, Mascagni F. Efficacy and tolerability of nebivolol compared with other antihypertensive drugs: a meta-analysis. Am J Cardiovasc Drugs. 2008;8(1):35–44.CrossRefPubMedGoogle Scholar
  50. 50.
    Slim HB, Black HR, Thompson PD. Older blood pressure medications—do they still have a place? Am J Cardiol. 2011;108(2):308–16.CrossRefPubMedGoogle Scholar
  51. 51.
    Powers BJ, Coeytaux RR, Dolor RJ, Hasselblad V, Patel UD, Yancy WS, et al. Updated report on comparative effectiveness of ACE inhibitors, ARBs, and direct renin inhibitors for patients with essential hypertension: much more data, little new information. J Gen Intern Med. 2012;27(6):716–29.CrossRefPubMedGoogle Scholar
  52. 52.
    Fisher ND, Meagher EA. Renin inhibitors. J Clin Hypertens. 2011;13(9):662–6.CrossRefGoogle Scholar
  53. 53.
    Dahlof B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359(9311):995–1003.CrossRefPubMedGoogle Scholar
  54. 54.
    Heart Outcomes Prevention Evaluation Study Investigators, Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145–53.CrossRefGoogle Scholar
  55. 55.
    Cardinal H, Monfared AA, Dorais M, LeLorier J. A comparison between persistence to therapy in ALLHAT and in everyday clinical practice: a generalizability issue. Can J Cardiol. 2004;20(4):417–21.PubMedGoogle Scholar
  56. 56.
    Kronish IM, Woodward M, Sergie Z, Ogedegbe G, Falzon L, Mann DM. Meta-analysis: impact of drug class on adherence to antihypertensives. Circulation. 2011;123(15):1611–21.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Ritchey M, Chang A, Powers C, Loustalot F, Schieb L, Ketcham M, et al. Vital signs: disparities in antihypertensive medication nonadherence among Medicare part D beneficiaries—United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(36):967–76.CrossRefPubMedGoogle Scholar
  58. 58.
    Tajeu GS, Kent ST, Kronish IM, Huang L, Krousel-Wood M, Bress AP, et al. Trends in antihypertensive medication discontinuation and low adherence among Medicare beneficiaries initiating treatment from 2007 to 2012. Hypertension. 2016;68(3):565–75.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Ah YM, Lee JY, Choi YJ, Kim B, Choi KH, Kong J, et al. Persistence with antihypertensive medications in uncomplicated treatment-naive patients: effects of initial therapeutic classes. J Korean Med Sci. 2015;30(12):1800–6.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Schulz M, Krueger K, Schuessel K, Friedland K, Laufs U, Mueller WE, et al. Medication adherence and persistence according to different antihypertensive drug classes: a retrospective cohort study of 255,500 patients. Int J Cardiol. 2016;220:668–76.CrossRefPubMedGoogle Scholar
  61. 61.
    Qvarnstrom M, Kahan T, Kieler H, Brandt L, Hasselstrom J, Bostrom KB, et al. Persistence to antihypertensive drug classes: a cohort study using the Swedish primary care cardiovascular database (SPCCD). Medicine (Baltimore). 2016;95(40):e4908.CrossRefGoogle Scholar
  62. 62.
    Choi YJ, Ah YM, Kong J, Choi KH, Kim B, Han N, et al. Implication of different initial beta blockers on treatment persistence: atenolol vs new-generation beta blocker, a population-based study. Cardiovasc Ther. 2016;34(4):268–75.CrossRefPubMedGoogle Scholar
  63. 63.
    Moise N, Schwartz J, Bring R, Shimbo D, Kronish IM. Antihypertensive drug class and adherence: an electronic monitoring study. Am J Hypertens. 2015;28(6):717–21.CrossRefPubMedGoogle Scholar
  64. 64.
    Dickerson JE, Hingorani AD, Ashby MJ, Palmer CR, Brown MJ. Optimisation of antihypertensive treatment by crossover rotation of four major classes. Lancet. 1999;353(9169):2008–13.CrossRefPubMedGoogle Scholar
  65. 65.
    Deary AJ, Schumann AL, Murfet H, Haydock SF, Foo RS, Brown MJ. Double-blind, placebo-controlled crossover comparison of five classes of antihypertensive drugs. J Hypertens. 2002;20(4):771–7.CrossRefPubMedGoogle Scholar
  66. 66.
    Edmonds D, Huss R, Jeck T, Mengden T, Schubert M, Vetter W. Individualizing antihypertensive therapy with enalapril versus atenolol: the Zurich experience. J Hypertens Suppl. 1990;8(4):S49–52.PubMedGoogle Scholar
  67. 67.
    Waeber B, Burnier M, Nussberger J, Brunner HR. Trials using a crossover design and ambulatory blood pressure recordings to determine the efficacy of antihypertensive agents in individual patients. J Hypertens Suppl. 1990;8(4):S37–41.PubMedGoogle Scholar
  68. 68.
    Sharma P, Fatibene J, Ferraro F, Jia H, Monteith S, Brown C, et al. A genome-wide search for susceptibility loci to human essential hypertension. Hypertension. 2000;35(6):1291–6.CrossRefPubMedGoogle Scholar
  69. 69.
    Gong Y, McDonough CW, Wang Z, Hou W, Cooper-DeHoff RM, Langaee TY, et al. Hypertension susceptibility loci and blood pressure response to antihypertensives: results from the pharmacogenomic evaluation of antihypertensive responses study. Circ Cardiovasc Genet. 2012;5(6):686–91.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Brunner HR, Menard J, Waeber B, Burnier M, Biollaz J, Nussberger J, et al. Treating the individual hypertensive patient: considerations on dose, sequential monotherapy and drug combinations. J Hypertens. 1990;8(1):3–11; discussion 3–9.CrossRefPubMedGoogle Scholar
  71. 71.
    Duan N, Kravitz RL, Schmid CH. Single-patient (n-of-1) trials: a pragmatic clinical decision methodology for patient-centered comparative effectiveness research. J Clin Epidemiol. 2013;66(8 Suppl):S21–8.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Kravitz RL, Duan N, editors, and the DEcIDE Methods Center N-of-1 Guidance Panel (Duan N, Eslick I, Gabler NB, Kaplan HC, Kravitz RL, Larson EB, Pace WD, Schmid CH, Sim I, Vohra S). Design and implementation of N-of-1 trials: a user’s guide. Rockville; 2014.Google Scholar
  73. 73.
    Mahon J, Laupacis A, Donner A, Wood T. Randomised study of n of 1 trials versus standard practice. BMJ. 1996;312(7038):1069–74.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1–32.CrossRefPubMedGoogle Scholar
  75. 75.
    Faria C, Wenzel M, Lee KW, Coderre K, Nichols J, Belletti DA. A narrative review of clinical inertia: focus on hypertension. J Am Soc Hypertens. 2009;3(4):267–76.CrossRefPubMedGoogle Scholar
  76. 76.
    Phillips LS, Twombly JG. It’s time to overcome clinical inertia. Ann Intern Med. 2008;148(10):783–5.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Stone AA, Shiffman S, Schwartz JE, Broderick JE, Hufford MR. Patient compliance with paper and electronic diaries. Control Clin Trials. 2003;24(2):182–99.CrossRefPubMedGoogle Scholar
  78. 78.
    Larson EB, Ellsworth AJ, Oas J. Randomized clinical trials in single patients during a 2-year period. JAMA. 1993;270(22):2708–12.CrossRefPubMedGoogle Scholar
  79. 79.
    Gabler NB, Duan N, Vohra S, Kravitz RL. N-of-1 trials in the medical literature: a systematic review. Med Care. 2011;49(8):761–8.CrossRefPubMedGoogle Scholar
  80. 80.
    Nikles CJ, Yelland M, Glasziou PP, Del Mar C. Do individualized medication effectiveness tests (n-of-1 trials) change clinical decisions about which drugs to use for osteoarthritis and chronic pain? Am J Ther. 2005;12(1):92–7.CrossRefPubMedGoogle Scholar
  81. 81.
    Nikles CJ, Clavarino AM, Del Mar CB. Using n-of-1 trials as a clinical tool to improve prescribing. Br J Gen Pract. 2005;55(512):175–80.PubMedPubMedCentralGoogle Scholar
  82. 82.
    Tarn DM, Heritage J, Paterniti DA, Hays RD, Kravitz RL, Wenger NS. Physician communication when prescribing new medications. Arch Intern Med. 2006;166(17):1855–62.CrossRefPubMedGoogle Scholar
  83. 83.
    Harmon G, Lefante J, Krousel-Wood M. Overcoming barriers: the role of providers in improving patient adherence to antihypertensive medications. Curr Opin Cardiol. 2006;21(4):310–5.CrossRefPubMedGoogle Scholar
  84. 84.
    Krumholz HM. Variations in health care, patient preferences, and high-quality decision making. JAMA. 2013;310(2):151–2.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Krumholz HM, Barreto-Filho JA, Jones PG, Li Y, Spertus JA. Decision-making preferences among patients with an acute myocardial infarction. JAMA Intern Med. 2013;173(13):1252–7.CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    Elley CR, Gupta AK, Webster R, Selak V, Jun M, Patel A, et al. The efficacy and tolerability of ‘polypills’: meta-analysis of randomised controlled trials. PLoS One. 2012;7(12):e52145.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Conn VS, Ruppar TM, Chase JA, Enriquez M, Cooper PS. Interventions to improve medication adherence in hypertensive patients: systematic review and meta-analysis. Curr Hypertens Rep. 2015;17(12):94.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for Behavioral Cardiovascular Health, Columbia University Medical CenterNew YorkUSA

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