Hypertension Excellence Centre, Division of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina, Greece.
Curr Vasc Pharmacol. 2020;18(4):410-417. doi: 10.2174/1570161117666190415112953.
The incidence of hypertension (HTN) and its cardiovascular (CV) complications are increasing throughout the world. Blood pressure (BP) control remains unsatisfactory worldwide. Medical inertia and poor adherence to treatment are among the factors that can partially explain, why BP control rate remains low. The introduction of a method for measuring the degree of adherence to a given medication is now a prerequisite. Complex treatment regimes, inadequate tolerance and frequent replacements of pharmaceutical formulations are the most common causes of poor adherence. In contrast, the use of stable combinations of antihypertensive drugs leads to improved patient adherence. We aim to review the relationships between arterial stiffness, cognitive function and adherence to medication in patients with HTN. Large artery stiffening can lead to HTN. In turn, arterial stiffness induced by HTN is associated with an increased CV and stroke risk. In addition, HTN can induce disorders of brain microcirculation resulting in cognitive dysfunction. Interestingly, memory cognitive dysfunction leads to a reduced adherence to drug treatment. Compliance with antihypertensive treatment improves BP control and arterial stiffness indices. Early treatment of arterial stiffness is strongly recommended for enhanced cognitive function and increased adherence.
高血压（HTN）的发病率及其心血管（CV）并发症在全球范围内不断增加。血压（BP）控制在全球范围内仍不尽如人意。医学惰性和治疗依从性差是导致 BP 控制率低的部分原因。引入一种测量对特定药物治疗的依从程度的方法现在是一个先决条件。复杂的治疗方案、耐受性不足和频繁更换药物制剂是依从性差的最常见原因。相比之下，使用稳定的降压药组合可提高患者的依从性。我们旨在回顾高血压患者的动脉僵硬、认知功能和药物治疗依从性之间的关系。大动脉僵硬可导致高血压。反过来，高血压引起的动脉僵硬与心血管和中风风险增加有关。此外，高血压可引起脑微循环障碍，导致认知功能障碍。有趣的是，记忆认知功能障碍导致药物治疗依从性降低。遵医嘱治疗高血压可改善血压控制和动脉僵硬指数。强烈建议早期治疗动脉僵硬，以增强认知功能和提高依从性。
