Antihypertensive therapy and medication adherence in patients with uncontrolled arterial hypertension

Abstract

Aim. To evaluate the antihypertensive therapy and adherence to treatment in patients with uncontrolled arterial hypertension.Materials and Мethods. The study included 297 patients hospitalized at the E.I. Chazov National Medical Research Center of Cardiology over the period from September 2019 to March 2022. Patients were spread into two groups depending on the increase in the frequency of BP: group 1 (n=149) – increase in BP above 140/90 mm Hg 1 or more per week while taking antihypertensive therapy with clinical manifestations, and group 2 (n=148) – increase in blood pressure more than 140/90 mm Hg less than 1 per week while taking antihypertensive therapy clinical manifestations. Antihypertensive therapy and medication adherence were assessed at hospital discharge and after 12 months.Results. Initially, the number of antihypertensive drugs was greater in patients with group 1 versus the patients with group 2 (p<0,001). The frequency of taking antihypertensive therapy initially and after 12 months was greater in group 1 (p<0,001). After 12 months, the number of antihypertensive drugs decreased in the group 1, and remained the same in group 2. When comparing the different classes of antihypertensive drugs, all classes, except angiotensin-converting enzyme inhibitors were most frequently prescribed in group 1 (p<0,05). After 12 months, a lower level of adherence was observed in group 1 patients compared to group 2 (6 [5-8] points vs. 8 [6-9] points) (p<0,001), as evidenced in the reduced intake of different classes of antihypertensive therapy.Conclusion. Uncontrolled arterial hypertension is a release of hypertension associated with more antihypertensive medications to be prescribed and adherence to be monitored more closely.