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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Veröffentlicht in:BMJ 2001-07, Vol.323 (7305), p.142-146
Hauptverfasser: Nuesch, Reto, Schroeder, Kerstin, Dieterle, Thomas, Martina, Benedict, Battegay, Edouard
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container_issue 7305
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creator Nuesch, Reto
Schroeder, Kerstin
Dieterle, Thomas
Martina, Benedict
Battegay, Edouard
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 &lt;135/85 mm Hg in patients aged ≥60 years and &lt;155/90 mm Hg in patients aged &gt;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 &lt;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. 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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 &lt;135/85 mm Hg in patients aged ≥60 years and &lt;155/90 mm Hg in patients aged &gt;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 &lt;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. 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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 &lt;135/85 mm Hg in patients aged ≥60 years and &lt;155/90 mm Hg in patients aged &gt;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 &lt;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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identifier ISSN: 0959-8138
ispartof BMJ, 2001-07, Vol.323 (7305), p.142-146
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source Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; MEDLINE; Alma/SFX Local Collection
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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