AHA: Chance to Win Cash Doubles Adherence to Blood Pressure Medication

THURSDAY, Nov. 13, 2025 (HealthDay News) — People with high blood pressure were twice as likely to take their blood pressure medication regularly when offered daily chances to win cash rewards, yet it led to similar blood pressure outcomes, according to a study published online Nov. 9 in the Journal of the American College of Cardiology to coincide with the American Heart Association Scientific Sessions 2025, held from Nov. 7 to 10 in New Orleans.

John A. Dodson, M.D., M.P.H., from the NYU Grossman School of Medicine in New York City, and colleagues randomly assigned safety-net clinic patients with hypertension who were prescribed at least one antihypertensive medication and had systolic blood pressure (BP) >140 mm Hg and poor self-reported adherence to either an incentive lottery administered via SMS messaging (265 intervention patients) or usual care (135 control patients).

The researchers found that at six months, intervention arm participants were twice as likely to achieve adequate adherence (71 versus 34 percent; adjusted risk ratio, 2.04; 95 percent confidence interval, 1.58 to 2.63). However, there was no significant change in mean systolic BP (−6.7 mm Hg intervention versus −5.8 mm Hg control; P = 0.62). Adherence was similar from six to 12 months (31 percent intervention versus 26 percent control; adjusted risk ratio, 1.17; 95 percent confidence interval, 0.83 to 1.65).

“We were also surprised that people did not keep taking their medication as prescribed after the rewards program ended,” Dodson said in a statement. “This shows that improving medication adherence is more complex than we thought. There are still many unknown factors we need to understand in order to help people adopt long-term behavior changes.”

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