Frishman William H
Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.
Cardiol Rev. 2007 Sep-Oct;15(5):257-63. doi: 10.1097/CRD.0b013e3180cabbe7.
An estimated 71 million individuals in the United States are currently diagnosed with cardiovascular disease (CVD). If untreated, CVD conditions such as systemic hypertension, coronary artery disease, and heart failure will have potentially serious and often fatal outcomes. Numerous clinical trials have established a variety of evidence-based medications that are efficacious in the treatment of CVD. These drugs will be ineffective, however, if patients have trouble adhering to their prescribed regimens. In patients with hypertension or heart failure, or in those who have suffered a myocardial infarction, poor adherence to therapies has been linked to a variety of problems, including poor blood pressure control, rehospitalization, and increased healthcare resource utilization. Both the asymptomatic nature of some forms of CVD and the high pill burden associated with certain therapies have been linked to poor adherence. Reducing pill burden through the use of once-daily formulations has proven valuable in improving adherence to evidence-based therapies. This review will discuss the impact of adherence to prescribed therapies for CVD, outline common barriers to adherence, and demonstrate the value of once-daily dosing regimens for improved patient adherence.
据估计，美国目前有7100万人被诊断患有心血管疾病（CVD）。如果不进行治疗，诸如系统性高血压、冠状动脉疾病和心力衰竭等心血管疾病状况可能会产生潜在的严重且往往致命的后果。众多临床试验已经确立了多种循证药物，这些药物在治疗心血管疾病方面是有效的。然而，如果患者难以坚持其规定的治疗方案，这些药物将无效。在高血压或心力衰竭患者中，或在曾发生心肌梗死的患者中，治疗依从性差与多种问题相关，包括血压控制不佳、再次住院以及医疗资源利用增加。某些形式的心血管疾病的无症状性质以及某些治疗方法带来的高服药负担都与依从性差有关。通过使用每日一次的制剂来减轻服药负担，已被证明对提高循证治疗的依从性很有价值。本综述将讨论坚持心血管疾病规定治疗的影响，概述依从性的常见障碍，并证明每日一次给药方案对提高患者依从性的价值。
