Cash Rewards Boost Blood Pressure Medication Adherence, But Don’t Lower Readings

People with high blood pressure were twice as likely to take their medication regularly when offered daily chances to win cash rewards. Surprisingly, this increased adherence didn’t translate to better blood pressure measurements, a new study reveals.

Preliminary findings from the Behavioral Economics Trial to Enhance Regulation of Blood Pressure (BETTER-BP) were presented on November 9 at the American Heart Association’s Scientific sessions 2025 in New orleans and published in the Journal of the American College of Cardiology (JACC). [JACC Link]

“We’re constantly seeking ways to improve medication adherence for patients with heart disease, and high blood pressure is a leading preventable risk factor,” explains John A. Dodson, MD, MPH, the study’s principal investigator and lead author. dr. Dodson directs NYU langone’s Geriatric Cardiology program and is an associate professor in the Department of Medicine’s Leon H. Charney Division of Cardiology at NYU Langone Health.

BETTER-BP involved 400 adults from three New York City community health clinics. These clinics primarily serve Medicaid patients and those without insurance-populations often facing uncontrolled blood pressure and treatment challenges. Uncontrolled high blood pressure significantly increases the risk of heart attacks and strokes, but is frequently enough manageable with consistent medication.

Participants were randomly divided into two groups. Roughly two-thirds entered a program offering cash rewards for taking their blood pressure medication, while the remaining third served as a control group. Before the study, all participants admitted to inconsistent medication adherence.

To accurately track medication intake, Dr. Dodson’s team used electronic pill bottles that recorded each opening, eliminating reliance on participant self-reporting.