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.
J Clin Hypertens (Greenwich). 2020 Apr;22(4):656-662. doi: 10.1111/jch.13830. Epub 2020 Feb 17.
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.
抗高血压药物治疗的依从性是医生在高血压治疗中经常面临的一个重要挑战。良好的依从性对于预防心血管并发症至关重要。因此,本研究旨在确定抗高血压治疗的依从性的流行率,并确定相关的临床变量。
这是一项在阿根廷 12 个城市进行的多中心横断面研究。采用系统抽样的方法选择接受药物治疗至少 6 个月的高血压患者。医生测量了三次血压,使用自我管理的 Morisky 问卷(MMAS-8)评估了依从性水平。参与者被分为三个依从性水平:高依从性-MMAS 评分 8 分;中依从性-MMAS 评分 6-<8 分;低依从性-MMAS 评分<6 分。本分析共纳入 1111 名个体(62±12 岁,女性 49.4%);159 名(14.3%)、329 名(29.6%)和 623 名(56.1%)患者的依从性分别为低、中、高。仅在高依从性患者中,高血压的控制率才有所提高:低、中、高依从性组的分别为 42.8%、42.2%和 64.5%。同样,仅在高依从性组中收缩压较低。高教育水平(OR 3.47,95%CI 2.68-4.49)和利尿剂治疗(OR 0.64,95%CI 0.47-0.88)是高依从性的独立预测因素。
总之,超过一半的接受治疗的高血压患者具有较高的依从性。这些患者的血压值较低,控制水平较高。高教育水平预示着高依从性。