Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study

BMJ. 2001 Jul 21;323(7305):142-6. doi: 10.1136/bmj.323.7305.142.

Abstract

Objectives: To prospectively compare compliance with treatment in patients with hypertension responsive to treatment versus patients with treatment resistant hypertension.

Design: Prospective case-control study.

Setting: Outpatient department in a large city hospital in Switzerland, providing primary, secondary, and tertiary care.

Participants: 110 consecutive medical outpatients with hypertension and taking stable treatment with at least two antihypertensive drugs for at least four weeks.

Main outcome measures: Treatment compliance assessed with MEMS devices; blood pressure determined by 12 hour daytime ambulatory monitoring (pressure <135/85 mm Hg in patients aged </=60 years and <155/90 mm Hg in patients aged >60 indicated hypertension responsive to treatment).

Results: Complete data were available for 103 patients, of whom 86 took >/=80% of their prescribed doses ("compliant") and 17 took <80% ("non-compliant"). Of the 49 patients with treatment resistant hypertension, 40 (82%) were compliant, while 46 (85%) of the 54 patients responsive to treatment were compliant.

Conclusion: Non-compliance with treatment was not more prevalent in patients with treatment resistant hypertension than in treatment responsive patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Monitoring, Ambulatory
  • Case-Control Studies
  • Drug Resistance
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypertension / psychology
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Treatment Refusal*

Substances

  • Antihypertensive Agents