HypertensionRandomised controlled trial

Behavioral Economics and Medication Adherence for Hypertension

J Am Coll CardiolPublished

  • Randomised controlled trial
  • 3 safety-net clinics

Authors' conclusion

In a diverse safety-net population, the BETTER-BP intervention doubled the rate of adequate antihypertensive medication adherence but did not reduce SBP at 6 months.

Study context

Population
Adults with hypertension on ≥1 antihypertensive medication, systolic blood pressure (SBP) >140 mm Hg and poor self-reported adherence, New York City safety-net clinics
Participants
400 adults
Comparison
mHealth incentive lottery vs control
  • Interventionn = 265
  • Controln = 135reference
Primary endpoint
Clinical: change in SBP; process: adequate antihypertensive medication adherence (≥80% days adherent)
Follow-up
6 months

Primary result

As reported in the abstract

Adjusted relative risk

2.04

95% CI 1.58–2.63

By group

Intervention

71%

Adequate adherence · Mean SBP change −6.7 mm Hg

Control

34%

Adequate adherence · Mean SBP change −5.8 mm Hg

Intervention vs Control
adjusted RR 2.04 (95% CI 1.58–2.63)

Further findings

OutcomeInterventionControladjusted RR (95% CI)
Adequate adherence · 6 to 12 months31%26%1.17 (0.83–1.65)

Original publication

Behavioral Economics and Medication Adherence for Hypertension. J Am Coll Cardiol. Published 18 November 2025. doi:10.1016/j.jacc.2025.10.062

Summarised from the published abstract; every number is checked against it