Predictors of Poor Adherence to Hypertension Treatment

Hypertension, a cardiovascular risk factor, is likely to lead to many complications.

To describe the therapeutic adherence and to identify the factors associated with poor adherence among hypertensive patients.        Methods: This is a descriptive cross-sectional study of 276 hypertensive patients, followed at « Riadh1 » Ksar Helal primary health center in the Monastir region over a six-month period from July 2016 to January 2017.

The mean age of our patients was 64.9 years ± 10.2 with a female predominance (69.9%). The subjects aged 65 and over accounted for 48.5% of the total number. The average duration of hypertension was 10.2 years (± 7.3). It was associated with diabetes in 174 (63%) patients. Compliant patients had a balanced blood pressure (p <0.001), a reduced drug intake (p = 0.001), a reduced tablet number (p = 0.02), and a good socioeconomic status (p = 0.006). Poor compliance is 2.3 times more likely to occur in women than men (<0.05). Having more than three tablets a day increases the risk of poor compliance by 4.2 (p<0.05). Patients with a low socio-economic level were 7 times more likely to be poor-compliant than those with a high socio-economic level (p<0.05).

Compliance to treatment was unsatisfactory in our hypertensive population, despite its important role in the balance of blood pressure. The family doctor should strengthen the therapeutic education of the hypertensive patient, its active involvement in the management of hypertension and the right choice of well tolerated antihypertensive molecules with the minimum daily intake.