Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
QJM. 2013 Oct;106(10):909-14. doi: 10.1093/qjmed/hct121. Epub 2013 May 20.
It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases.
To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan Potassium and Hydrochlorothiazide for Improvement of Medication Compliance Trial (COMFORT) study.
An observational analysis from a randomized controlled trial.
A total of 203 hypertensive subjects were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or two pills, an angiotensin II receptor blocker and a thiazide diuretic. Medication adherence calculated based on pill counts and BPs was evaluated at 1, 3 and 6 months after randomization.
The subjects were divided into three groups according to their adherence, i.e. relatively low-adherence (<90%; n = 19), moderate-adherence (90-99%; n = 71) and high-adherence (100%; n = 113) groups. Clinical characteristics of the subjects including BP, sex, randomized treatments and past medical history did not differ significantly among the three groups. Achieved follow-up BPs over the 6-month treatment period, which were adjusted for age, sex, baseline BP and randomized treatment, were significantly higher in the low-adherence group (135/78 mmHg) compared with the high-adherence (130/74 mmHg; P = 0.02/0.02) and the moderate-adherence (128/74 mmHg; P = 0.003/0.02) groups.
Low adherence to an antihypertensive-drug regimen was associated with poor BP control.
降压药物治疗的依从性是否会影响高血压患者的血压控制，这一点尚未得到充分阐明。
利用洛沙坦钾氢氯噻嗪联合片改善药物治疗依从性试验（COMFORT）研究的数据，调查降压药物治疗方案依从性与血压控制之间的关联。
这是一项来自随机对照试验的观察性分析。
共 203 例高血压患者被随机分为每日服用复方制剂（氯沙坦 50mg/氢氯噻嗪 12.5mg）或两种药物（血管紧张素Ⅱ受体阻滞剂和噻嗪类利尿剂）组。根据药物计数和血压评估，在随机分组后 1、3 和 6 个月时评估药物依从性。
根据患者的依从性，将其分为三组，即相对低依从性组（<90%；n=19）、中依从性组（90%-99%；n=71）和高依从性组（100%；n=113）。三组患者的临床特征（包括血压、性别、随机治疗和既往病史）无显著差异。调整年龄、性别、基线血压和随机治疗后，在 6 个月治疗期间的随访血压在低依从性组（135/78mmHg）明显高于高依从性组（130/74mmHg；P=0.02/0.02）和中依从性组（128/74mmHg；P=0.003/0.02）。
降压药物治疗方案依从性低与血压控制不良相关。
