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Adherence to antihypertensive agents and blood pressure control in chronic kidney disease

Kristen E Schmitt1, Christine F Edie, Paul Laflam

  • 1Cincinnati Veterans Affairs Medical Center, University of Cincinnati, Cincinnati, Ohio 45220, USA.

American Journal of Nephrology
|November 3, 2010
PubMed

Insights

Medication adherence in chronic kidney disease (CKD) is crucial for managing hypertension. Poor adherence to blood pressure medications is linked to uncontrolled hypertension, highlighting the need for improved monitoring in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Hypertension is a significant, modifiable risk factor in chronic kidney disease (CKD).
  • Medication adherence (MA) is essential for achieving blood pressure (BP) treatment goals in CKD patients.
  • Current understanding of antihypertensive medication adherence patterns and their impact on BP in CKD settings is limited.

Purpose of the Study:

  • To investigate patterns of medication adherence (MA) for antihypertensive agents in patients with chronic kidney disease (CKD).
  • To determine the impact of MA on blood pressure (BP) control within CKD practice settings.
  • To analyze the relationship between MA and BP levels in a large cohort of CKD patients.

Main Methods:

  • A cohort of 7,227 CKD patients prescribed antihypertensive medications between 2006-2007 was analyzed.
  • Medication adherence was assessed using the medication possession ratio (MPR).
  • Logistic regression models were employed to examine the association between MA and BP control.

Main Results:

  • 67% of patients exhibited good MA (MPR ≥ 0.8), with adherence varying by drug class.
  • MPR significantly declined with worsening CKD stages (III, IV, V) and was negatively impacted by hospitalizations.
  • Poor MA was independently associated with elevated BP (OR 1.23, 95% CI 1.11-1.37), with only 35% of patients achieving normal BP.

Conclusions:

  • Approximately 33% of CKD patients demonstrate poor MA to antihypertensive medications.
  • Medication adherence deteriorates as renal function declines in CKD patients.
  • Improving MA monitoring and interventions in CKD care may lead to better hypertension management and patient outcomes.
Abstract

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