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Nonadherence and uncontrolled arterial hypertension in Croatia-Insights from the May Measurement Month 2023 campaign

Valerija Bralić Lang1,2,3, Ana Soldo2,4, Olgica Velkovski Škopić2,5

  • 1University of Zagreb, School of Medicine, Zagreb, Croatia.

British Journal of Clinical Pharmacology
|October 17, 2025
PubMed

Insights

Nearly one-third of hypertensive patients in Croatia are nonadherent to medication, impacting blood pressure control. Interventions targeting younger men and urban residents are crucial for better cardio-kidney-metabolic outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Pharmacology

Background:

  • Hypertension management requires consistent medication adherence.
  • Non-adherence to antihypertensive medicines is a significant barrier to achieving blood pressure control.
  • The May Measurement Month (MMM) initiative aims to raise awareness and screen for hypertension globally.

Purpose of the Study:

  • To determine the prevalence of non-adherence to antihypertensive medicines.
  • To identify demographic and behavioral factors associated with non-adherence.
  • To assess the impact of non-adherence on blood pressure control within the MMM 2023 Croatia cohort.

Main Methods:

  • Cross-sectional, opportunistic screening study involving 8739 subjects in 329 community pharmacies.
  • Utilized an extended MMM questionnaire including the 5-item Medication Adherence Report Scale (MARS).
  • Assessed adherence, salt intake, mobile phone usage, and performed three blood pressure measurements.

Main Results:

  • 68.2% of hypertensive (HT) participants were adherent to their medication.
  • Non-adherence was more prevalent in men, urban residents, and younger individuals.
  • Non-adherence was significantly associated with poorer blood pressure control (p < 0.05).

Conclusions:

  • Approximately one-third of hypertensive patients in Croatia exhibit non-adherence to prescribed medications.
  • This non-adherence contributes to suboptimal blood pressure control and adverse cardio-kidney-metabolic outcomes.
  • Routine adherence screening and targeted interventions are essential, especially for younger men and urban populations.
Abstract

Keywords:
MARS‐5MMM campaignarterial hypertensionblood pressure controlmedication adherence

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