The effect of psychiatric comorbidity on hypertensive patients' perception of medication side-effects

Arterial hypertension is a public health emergency in developing countries. Poor adherence is the most important cause of uncontrolled hypertension. Many patients cite medication adverse effects as the cause for non-adherence. It remains to be seen whether the perception of medication side-effects is a function of the patients' psychological state. We estimated the prevalence of medication intolerance in patients attending the cardiology outpatient department of a state medical college. We also distinguished between intolerance due medication side-effects that were specific to the particular drug(s) being used and that due to non-specific adverse effects. Thereafter the statistical correlation between intolerance (specific or non-specific) and psychiatric comorbidity in this population was estimated. Psychiatric comorbidity showed the highest correlation with intolerance due to non-specific side-effects of antihypertensive medications (p = 0.01). This was followed by male sex and duration of illness. The correlation remained valid even after adjusting for factors like presence of physical comorbidity, individual income per month, number of pills taken, number of doses per day and distance of referral centre from place of residence.