Related Experiment Videos

Treatment adherence and blood pressure control in older individuals with hypertension

Rachel G Bastos-Barbosa1, Eduardo Ferriolli, Julio C Moriguti

  • 1Departamento de Medicina Interna, Escola de Medicina, Universidade de São Paulo, Ribeirão Preto, Brazil.

Arquivos Brasileiros De Cardiologia
|June 13, 2012
PubMed

Insights

Treatment adherence in older adults with hypertension was low, but blood pressure control was high, especially when including the white-coat effect. Different adherence measurement tools showed poor agreement, highlighting challenges in assessing patient compliance.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Non-adherence to hypertension treatment is a primary cause of uncontrolled blood pressure (BP).
  • Older individuals may face increased risks associated with uncontrolled BP due to treatment non-adherence.

Purpose of the Study:

  • To evaluate and compare adherence rates to hypertension treatment using various methods.
  • To estimate the blood pressure control rate in older hypertensive patients.
  • To investigate the association between BP control and treatment adherence.

Main Methods:

  • Adherence assessed in older hypertensive patients using Morisky-Green test, Attitude regarding Medication Intake (AMI), Nurse Adherence Evaluation (NAE), and Home Adherence Evaluation (HAE).
  • Salt intake estimated via 24-hour urinary sodium excretion.
  • Blood pressure control measured by awake ambulatory blood pressure monitoring.

Main Results:

  • Poor concordance observed between Morisky-Green test and AMI (Kappa=0.27) or NAE (Kappa=0.05); moderate concordance with HAE.
  • Eighty percent of patients achieved controlled BP, with 42% exhibiting the white-coat effect.
  • Lower salt excretion group showed better medication adherence (p<0.001) and reported salt avoidance more frequently (p<0.001).

Conclusions:

  • Existing adherence assessment tools demonstrated poor agreement with the reference Morisky-Green test.
  • Hypertension treatment adherence was generally low among the study population.
  • High BP control rates were achieved, particularly when including patients with the white-coat effect.
Abstract

Related Concept Videos

Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...