Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study
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, providi...
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description | 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 |
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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. What is already known on this topic For many patients with arterial hypertension, blood pressure cannot be adequately controlled despite treatment with antihypertensive drugs Patients' poor compliance with treatment is often suggested as the reason for lack of response to antihypertensive drugs What this study adds When treatment compliance was monitored in hypertensive patients following stable treatment regimens, no difference in compliance was found between those with treatment resistant hypertension and those responsive to treatment Factors other than patients' compliance with treatment regimens should be examined to explain lack of response to antihypertensive drugs</description><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>ISSN: 0959-535X</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.323.7305.142</identifier><identifier>PMID: 11463685</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Aged ; Ambulatory blood pressure ; Antihypertensive agents ; Antihypertensive Agents - therapeutic use ; Antihypertensives ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood pressure ; Blood Pressure Monitoring, Ambulatory ; Cardiology. Vascular system ; Cardiovascular system ; Case-Control Studies ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Compliance ; Dosage ; Drug Resistance ; Female ; Humans ; Hypertension ; Hypertension - drug therapy ; Hypertension - physiopathology ; Hypertension - psychology ; Male ; Medical sciences ; Medication adherence ; Microelectromechanical systems ; Middle Aged ; Patient compliance ; Pharmacology. Drug treatments ; Primary Care ; Prospective Studies ; Pulmonary compliance ; Resistance ; Switzerland ; Treatment ; Treatment compliance ; Treatment Outcome ; Treatment Refusal</subject><ispartof>BMJ, 2001-07, Vol.323 (7305), p.142-146</ispartof><rights>2001 BMJ Publishing Group Ltd.</rights><rights>Copyright 2001 BMJ</rights><rights>2001 INIST-CNRS</rights><rights>Copyright: 2001 (c) 2001 BMJ Publishing Group Ltd.</rights><rights>Copyright © 2001, BMJ 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b574t-116df049dacd5dd6a960d2dccee826284815a9f69e5f7b3d7b08c35aef214b083</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/25467428$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/25467428$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,776,780,799,881,27901,27902,30977,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1073733$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11463685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nuesch, Reto</creatorcontrib><creatorcontrib>Schroeder, Kerstin</creatorcontrib><creatorcontrib>Dieterle, Thomas</creatorcontrib><creatorcontrib>Martina, Benedict</creatorcontrib><creatorcontrib>Battegay, Edouard</creatorcontrib><title>Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study</title><title>BMJ</title><addtitle>BMJ</addtitle><description>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. What is already known on this topic For many patients with arterial hypertension, blood pressure cannot be adequately controlled despite treatment with antihypertensive drugs Patients' poor compliance with treatment is often suggested as the reason for lack of response to antihypertensive drugs What this study adds When treatment compliance was monitored in hypertensive patients following stable treatment regimens, no difference in compliance was found between those with treatment resistant hypertension and those responsive to treatment Factors other than patients' compliance with treatment regimens should be examined to explain lack of response to antihypertensive drugs</description><subject>Aged</subject><subject>Ambulatory blood pressure</subject><subject>Antihypertensive agents</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Antihypertensives</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood pressure</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Case-Control Studies</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Compliance</subject><subject>Dosage</subject><subject>Drug Resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - psychology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication adherence</subject><subject>Microelectromechanical systems</subject><subject>Middle Aged</subject><subject>Patient compliance</subject><subject>Pharmacology. Drug treatments</subject><subject>Primary Care</subject><subject>Prospective Studies</subject><subject>Pulmonary compliance</subject><subject>Resistance</subject><subject>Switzerland</subject><subject>Treatment</subject><subject>Treatment compliance</subject><subject>Treatment Outcome</subject><subject>Treatment Refusal</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>7QJ</sourceid><recordid>eNqFksuO0zAUhiMEYqoyezagSCA2KMWOYzsZsUEVN1GKhAa2luOcUJfEDrYzQx-Bt8ZRqs7AZryx5fP9R-fyJ8ljjFYYE_aq7vcrkpMVJ4iucJHfSxa4YGVGS0LuJwtU0SorMSnPknPv9wihnPCyYvRhcoYjSFhJF8mfr9DJoK1JawjXACbVxo9tq5UGE1IHfrDGQxpsKk3Qu8MALoDx-ir-OZChnzBpmnSw1qXK9kOnpVGQXuuwu0EuUpkOzvoBVJi0SnrIlDXB2S71YWwOj5IHrew8nB_vZfLt3dvL9Yds8-X9x_WbTVZTXoQMY9a0qKgaqRraNExWDDV5oxRAmbO8LEpMZdWyCmjLa9LwGpWKUAltjov4Jsvk9Zx3GOseGhWLc7ITg9O9dAdhpRb_RozeiR_2SpCC5zzKXxzlzv4awQfRa6-g66QBO3rBMcKMsupOkHKOco4n8Nl_4N6OzsQZCMzjoSWL21omaKZUnKJ30J4qxkhMfhDRDyL6QUx-ENEPUfL0dqc3guP2I_D8CEivZNe6uDjtbyXmhBMSsScztvfBulM4pwXjRT5NNJvj2gf4fYpL91OwmIGK7fe1-LxZs8vtp62YWnk581PFd3bxF5GD6Qo</recordid><startdate>20010721</startdate><enddate>20010721</enddate><creator>Nuesch, Reto</creator><creator>Schroeder, Kerstin</creator><creator>Dieterle, Thomas</creator><creator>Martina, Benedict</creator><creator>Battegay, Edouard</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20010721</creationdate><title>Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study</title><author>Nuesch, Reto ; Schroeder, Kerstin ; Dieterle, Thomas ; Martina, Benedict ; Battegay, Edouard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b574t-116df049dacd5dd6a960d2dccee826284815a9f69e5f7b3d7b08c35aef214b083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Ambulatory blood pressure</topic><topic>Antihypertensive agents</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Antihypertensives</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood pressure</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Case-Control Studies</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Compliance</topic><topic>Dosage</topic><topic>Drug Resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - physiopathology</topic><topic>Hypertension - psychology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication adherence</topic><topic>Microelectromechanical systems</topic><topic>Middle Aged</topic><topic>Patient compliance</topic><topic>Pharmacology. Drug treatments</topic><topic>Primary Care</topic><topic>Prospective Studies</topic><topic>Pulmonary compliance</topic><topic>Resistance</topic><topic>Switzerland</topic><topic>Treatment</topic><topic>Treatment compliance</topic><topic>Treatment Outcome</topic><topic>Treatment Refusal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nuesch, Reto</creatorcontrib><creatorcontrib>Schroeder, Kerstin</creatorcontrib><creatorcontrib>Dieterle, Thomas</creatorcontrib><creatorcontrib>Martina, Benedict</creatorcontrib><creatorcontrib>Battegay, Edouard</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nuesch, Reto</au><au>Schroeder, Kerstin</au><au>Dieterle, Thomas</au><au>Martina, Benedict</au><au>Battegay, Edouard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2001-07-21</date><risdate>2001</risdate><volume>323</volume><issue>7305</issue><spage>142</spage><epage>146</epage><pages>142-146</pages><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>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. What is already known on this topic For many patients with arterial hypertension, blood pressure cannot be adequately controlled despite treatment with antihypertensive drugs Patients' poor compliance with treatment is often suggested as the reason for lack of response to antihypertensive drugs What this study adds When treatment compliance was monitored in hypertensive patients following stable treatment regimens, no difference in compliance was found between those with treatment resistant hypertension and those responsive to treatment Factors other than patients' compliance with treatment regimens should be examined to explain lack of response to antihypertensive drugs</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>11463685</pmid><doi>10.1136/bmj.323.7305.142</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Ambulatory blood pressure Antihypertensive agents Antihypertensive Agents - therapeutic use Antihypertensives Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood pressure Blood Pressure Monitoring, Ambulatory Cardiology. Vascular system Cardiovascular system Case-Control Studies Clinical manifestations. Epidemiology. Investigative techniques. Etiology Compliance Dosage Drug Resistance Female Humans Hypertension Hypertension - drug therapy Hypertension - physiopathology Hypertension - psychology Male Medical sciences Medication adherence Microelectromechanical systems Middle Aged Patient compliance Pharmacology. Drug treatments Primary Care Prospective Studies Pulmonary compliance Resistance Switzerland Treatment Treatment compliance Treatment Outcome Treatment Refusal |
title | Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study |
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