Effect of medication adherence on blood pressure control and risk factors for antihypertensive medication adherence

J Eval Clin Pract. 2015 Feb;21(1):166-72. doi: 10.1111/jep.12268. Epub 2014 Oct 16.


Rationale, aims and objectives: We aim to investigate a range of risk factors associated with medication adherence among Chinese hypertensive patients. We also aim to investigate the association between medication adherence and blood pressure control.

Methods: A cross-sectional study was conducted among Chinese hypertensive patients in a comprehensive teaching hospital in Shanghai, China, using a validated scale, a self-designed questionnaire and patients' medical records.

Results: Of the 232 eligible participants, 61 (26.3%), 51 (22.0%) and 120 (51.7%) showed low, medium and high adherence, respectively. Adjusted for socio-demographic, clinical and patient-related factors, antihypertensive medication adherence was significantly associated with better systolic blood pressure control (P=0.001), whereas the association with diastolic blood pressure control was relatively weak (P=0.334). In the multivariate analysis, patients with longer duration of drug use [P=0.012, odds ratio (OR)=0.46, 95% confidence interval (CI) 0.25-0.84], combination of antiplatelet agents (0.002, 0.38, 0.20-0.71), less concerns of medical cost (0.001, 0.18, 0.02-0.51), more availability of professional guidance (0.002, 0.34, 0.17-0.66) and more availability of family support (0.036, 0.51, 0.27-0.96) were more likely to adhere to their drug regimens.

Conclusions: The rate of suboptimal medication adherence among Chinese hypertensive patients is quite high. Interventions could focus upon the risk factors to improve antihypertensive medication adherence in clinical practice.

Keywords: Chinese; clinical outcome; hypertension; medication adherence; risk factors; social support.

MeSH terms

  • Aged
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • China / epidemiology
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hospitals, Teaching
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Social Support
  • Socioeconomic Factors
  • Time Factors


  • Antihypertensive Agents