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Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a
R Nuesch1, K Schroeder, T Dieterle
1Outpatient Department of Internal Medicine, University Hospital, CH-4031 Basle, Switzerland.
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 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.