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Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7305.142 (Published 21 July 2001) Cite this as: BMJ 2001;323:142

This article has a correction. Please see:

  1. Reto Nuesch, senior registrar,
  2. Kerstin Schroeder, junior fellow,
  3. Thomas Dieterle, senior fellow,
  4. Benedict Martina, head of medical emergencies,
  5. Edouard Battegay (ebattegay{at}uhbs.ch), assistant professor of internal medicine
  1. Outpatient Department of Internal Medicine, University Hospital, CH-4031 Basle, Switzerland
  1. Correspondence to: E Battegay
  • Accepted 21 May 2001

Abstract

Objectives: To prospectively compare compliance with treatment in patients with hypertension responsive to treatment versus patients with treatment resistant hypertension.

Design: Prospective case-control study.

Setting: Outpatient department in a large city hospital in Switzerland, providing primary, secondary, and tertiary care.

Participants: 110 consecutive medical outpatients with hypertension and taking stable treatment with at least two antihypertensive drugs for at least four weeks.

Main outcome measures: Treatment compliance assessed with MEMS devices; blood pressure determined by 12 hour daytime ambulatory monitoring (pressure <135/85 mm Hg in patients aged ≥60 years and <155/90 mm Hg in patients aged >60 indicated hypertension responsive to treatment).

Results: Complete data were available for 103 patients, of whom 86 took ≥80% of their prescribed doses (“compliant”) and 17 took <80% (“non-compliant”). Of the 49 patients with treatment resistant hypertension, 40 (82%) were compliant, while 46 (85%) of the 54 patients responsive to treatment were compliant.

Conclusion: Non-compliance with treatment was not more prevalent in patients with treatment resistant hypertension than in treatment responsive patients.

What is already known on this topic

What is already known on this topic For many patients with arterial hypertension, blood pressure cannot be adequately controlled despite treatment with antihypertensive drugs

Patients' poor compliance with treatment is often suggested as the reason for lack of response to antihypertensive drugs

What this study adds

What this study adds When treatment compliance was monitored in hypertensive patients following stable treatment regimens, no difference in compliance was found between those with treatment resistant hypertension and those responsive to treatment

Factors other than patients' compliance with treatment regimens should be examined to explain lack of response to antihypertensive drugs

Footnotes

  • Funding EB was supported by a SCORE grant (32-31948) from the Swiss National Science Foundation. The study was further supported by an unrestricted research grant from the pharmaceutical company Pfizer AG, Switzerland.

  • Competing interests None declared.

  • Accepted 21 May 2001
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