Elliott William J
Department of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612-3244, USA.
J Clin Hypertens (Greenwich). 2008 Jan;10(1 Suppl 1):20-6. doi: 10.1111/j.1524-6175.2007.08028.x.
Inadequate control of blood pressure may be attributed to both provider-related and patient-related factors. Health care provider-related factors may include an excessive reliance on monotherapy and reluctance to increase drug doses or add additional antihypertensive agents to the treatment regimen. The primary patient-related factor is nonadherence with the prescribed antihypertensive medication. Although the high cost of therapy is sometimes a reason for poor adherence, drug side effects or dosing considerations may be more important factors. Better adherence with antihypertensive medication is associated with a significantly greater likelihood of achieving blood pressure control and, consequently, with lower costs and reduced utilization of health care resources. Therefore, strategies that improve long-term adherence should be adopted. Single-pill, or fixed-dose, combination therapy is one approach that improves adherence, while also providing the antihypertensive efficacy needed to help patients achieve their blood pressure goals.
血压控制不佳可能归因于与医疗服务提供者相关的因素和与患者相关的因素。与医疗服务提供者相关的因素可能包括对单一疗法的过度依赖，以及不愿增加药物剂量或在治疗方案中添加其他抗高血压药物。与患者相关的主要因素是不依从规定的抗高血压药物治疗。尽管治疗费用高昂有时是依从性差的一个原因，但药物副作用或给药考虑因素可能是更重要的因素。更好地依从抗高血压药物治疗与实现血压控制的可能性显著增加相关，因此，与更低的成本和减少医疗资源利用相关。因此，应采用改善长期依从性的策略。单片或固定剂量联合疗法是一种改善依从性的方法，同时还能提供帮助患者实现血压目标所需的抗高血压疗效。
