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Espeche W, Salazar MR, Sabio R, Diaz A, Leiva Sisnieguez C, Olano D, Balbin E, Renna N, Grosse P, Flores RA, Lagos AC, Ferrer P, Poppe S, Risso Patron F, Sotnieczuk Stasiuk VD, Valentini E, Cardozo JR, Romano JR, Parodi R, Carbajal H. Adherence to antihypertensive drug treatment in Argentina: A multicenter study. J Clin Hypertens (Greenwich) 2020; 22:656-662. [PMID: 32065507 DOI: 10.1111/jch.13830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/15/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
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.
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Affiliation(s)
- Walter Espeche
- Unidad de Enfermedades Cardiometabólicas, Hospital San Martin de La Plata, Buenos Aires, Argentina.,Cátedra D Clínica Médica, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Martin R Salazar
- Unidad de Enfermedades Cardiometabólicas, Hospital San Martin de La Plata, Buenos Aires, Argentina.,Cátedra D Clínica Médica, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Rodrigo Sabio
- Servicio de Medicina Interna Hospital SAMIC de Alta Complejidad, ciudad de El Calafate, Argentina
| | - Alejandro Diaz
- CCT Instituto de Investigación en Ciencias de la Salud UNICEN, CCT-CONICET, Tandil, Buenos Ires, Argentina
| | - Carlos Leiva Sisnieguez
- Unidad de Enfermedades Cardiometabólicas, Hospital San Martin de La Plata, Buenos Aires, Argentina.,Cátedra D Clínica Médica, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Daniel Olano
- Unidad de Enfermedades Cardiometabólicas, Hospital San Martin de La Plata, Buenos Aires, Argentina
| | - Eduardo Balbin
- Unidad de Enfermedades Cardiometabólicas, Hospital San Martin de La Plata, Buenos Aires, Argentina
| | | | - Pedro Grosse
- Centro privado de cardiología, Tucumán, Argentina
| | - Roberto A Flores
- Cátedra de Semiología Facultad de Ciencias Médicas, Universidad Nacional de Santiago del Estero, Santiago del Estero, Argentina
| | - Ana C Lagos
- Centro de Diagnóstico Cardiovascular, Concordia, Argentina
| | - Pablo Ferrer
- Hospital Fernandez, CABA, Buenos Aires, Argentina
| | - Silvia Poppe
- Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | | | | | - Elina Valentini
- Servicio de Clínica Médica, Sanatorio de La Mujer, Rosario, Argentina
| | - Jose R Cardozo
- Hospital Justo Pereyra Aristóbulo del Valle, Misiones, Argentina
| | | | - Roberto Parodi
- Primera Cátedra de Clínica Médica y Terapéutica, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Horacio Carbajal
- Cátedra D Clínica Médica, Universidad Nacional de La Plata, Buenos Aires, Argentina
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