Costa F V
Clinica Medica III, Policlinico S.Orsola, Università di Bologna, Italy.
Clin Exp Hypertens. 1996 Apr-May;18(3-4):463-72. doi: 10.3109/10641969609088977.
Compliance to antihypertensive treatment is a critical factor conditioning the success of therapy. It has been calculated that, depending on the method used to monitor compliance, only 20 to 80% of treated hypertensives can be considered as good compliers. In the past years it was thought that compliance was only a patient's problem but instead, the role of the physician in determining patient's compliance is very important. He should give clear information about the risks of the disease, the advantages of therapy and how to take medicines. He should also prescribe a therapeutic scheme as simple as possible avoiding multiple drug administrations and informing patients about possible side-effects. Subjects at particular risk of poor compliance (middle aged males, still active in work, without previous cardiovascular diseases) must be particularly monitored. In any case of poor response to therapy it is important to suspect poor compliance. A standardization of the methods for recording compliance is needed especially in clinical trials. The results of experimental studies in fact can be misleading if compliance is not taken into account.
对抗高血压治疗的依从性是决定治疗成功与否的关键因素。据计算，根据用于监测依从性的方法不同，接受治疗的高血压患者中只有20%至80%可被视为依从性良好。在过去几年中，人们认为依从性只是患者的问题，但实际上，医生在确定患者依从性方面的作用非常重要。他应该清楚地告知患者疾病的风险、治疗的益处以及如何服药。他还应该制定尽可能简单的治疗方案，避免多种药物联合使用，并告知患者可能出现的副作用。对于依从性差风险较高的人群（中年男性，仍在积极工作，无既往心血管疾病史）必须进行特别监测。在任何治疗反应不佳的情况下，怀疑依从性差都很重要。尤其在临床试验中，需要对记录依从性的方法进行标准化。事实上，如果不考虑依从性，实验研究的结果可能会产生误导。
