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Adherence to antihypertensive drug treatment in Argentina: A multicenter study
Authors:Walter Espeche  Martin R Salazar  Rodrigo Sabio  Alejandro Diaz  Carlos Leiva Sisnieguez  Daniel Olano  Eduardo Balbin  Nicolas Renna  Pedro Grosse  Roberto A Flores  Ana C Lagos  Pablo Ferrer  Silvia Poppe  Facundo Risso Patron  Victor D Sotnieczuk Stasiuk  Elina Valentini  Jose R Cardozo  Jose R Romano  Roberto Parodi  Horacio Carbajal
Abstract:Adherence to antihypertensive medication is an important challenge that doctors often face in the treatment of hypertension. Good adherence is crucial to prevent cardiovascular complications. In consequence, the present study aimed at determining the prevalence of adherence to antihypertensive treatment and identifying associated clinical variables. A multicenter cross‐sectional study was conducted in 12 cities of Argentina. A systematic sampling was performed in order to select patients with hypertension and under pharmacological treatment for at least 6 months. Physicians took three BP measurements, and the level of adherence was assessed using the self‐administered Morisky questionnaire (MMAS‐8). Participants were classified into three levels of adherence: high adherence—MMAS score of 8; medium adherence—MMAS scores of 6 to <8; and low adherence—MMAS scores of <6. A total of 1111 individuals (62 ± 12 years old, women 49.4%) were included in the present analysis; 159 (14.3%), 329 (29.6%) and 623 (56.1%) patients had low, medium, and high adherence, respectively. The prevalence of controlled hypertension increased only in high adherent patients: 42.8%, 42.2%, and 64.5% for low, medium, and high adherence groups, respectively. Similarly, systolic BP was lower only in the high adherence group. High educational level (OR 3.47, 95% CI 2.68‐4.49) and diuretic treatment (OR 0.64, 95% CI 0.47‐0.88) were independent predictors of high adherence. In conclusion, more than a half of treated hypertensive patients had a high level of adherence. These patients had lower BP values and higher control levels. A high educational level predicts high adherence.
Keywords:adherence  antihypertensive drugs  cross‐sectional study
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