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Hypertension and current issues in compliance and patient outcomes

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Abstract

Economic and human costs associated with untreated or inadequately controlled hypertension and its complications continue to be an issue in the United States despite the availability of numerous antihypertensive agents. Knowledge of hypertension, product profiles, tolerability concerns, convenience of dosing, health-related quality of life effects, and cost of therapy are some of the factors that may influence the compliance of patients to their medication regimens. Recent reports on patient noncompliance have focused on patient-provider relationships, psychosocial barriers, home blood pressure monitoring, and electronic monitoring systems to improve blood pressure control. The use of health-related quality of life assessment in antihypertensive studies and in routine clinical practice provides another opportunity to optimize a patient‘s regimen for short-and long-term hypertension control in a cost-effective manner.

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References and Recommended Reading

  1. Burt VL, Cutler Ja, Higgins M, et al.: Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population: data from the Health Examination Surveys, 1960 to 1991. Hypertension 1995, 26:60–69.

    PubMed  CAS  Google Scholar 

  2. American Heart association. http://www.americanheart.org. July 20, 2000.

  3. Ebrahim S: Detection, adherence and control of hypertension for the prevention of stroke: a systematic review. Health Technol assessment 1998, 2:20–28.

    Google Scholar 

  4. Dusing R, Weisser B, Mengden T, et al.: Changes in antihypertensive therapy — the role of adverse effects and adherence. Blood Press 1998, 7:313–315.

    Article  PubMed  CAS  Google Scholar 

  5. Kjellgren KI, Svesson S, Ahlner J, et al.: antihypertensive medication in clinical encounters. Int J Cardiol 1998, 64:161–169.

    Article  PubMed  CAS  Google Scholar 

  6. Hill MN, Bone LR, Kim MT, et al.: Barriers to hypertension care and control in young urban black men. am J Hypertens. 1999, 12:951–958. This study demonstrates success in developing comprehensive and culturally meaningful interventions to increase compliance with antihypertensive regimens.

    Article  PubMed  CAS  Google Scholar 

  7. Vaur L, Vaisse B, Genes N, et al.: Use of electronic pill boxes to assess risk of poor treatment adherence. am J Hypertens. 1999, 12:374–380.

    Article  PubMed  CAS  Google Scholar 

  8. Andrejak M, Genes N, Vaur L, et al.: Electronic pill-boxes in the evaluation of antihypertensive treatment adherence: comparison of once daily versus twice daily regimen. am J Hypertens. 2000, 13:184–190.

    Article  PubMed  CAS  Google Scholar 

  9. Mounier-Vehier C, Bernaud C, Carré A, et al.: Compliance and antihypertensive efficacy of amlodipine compared with nifedipine slow-release. am J Hypertens 1998, 11:478–486.

    Article  PubMed  CAS  Google Scholar 

  10. Waeber B, Burnier M, Brunner HR: Compliance with antihypertensive therapy. Clin Exp Hypertens 1999, 21:973–985.

    Article  PubMed  CAS  Google Scholar 

  11. Waeber B, Vetter W, Darioli R, et al.: Improved blood pressure control by monitoring adherence with antihypertensive therapy. Int J Clin Pract 1999, 53:37–38. Significant reductions in blood pressure were seen after using the MEMS cap to monitor patient compliance. The use of this device also assisted in differentiating between nonresponders and noncompliers.

    PubMed  CAS  Google Scholar 

  12. Ashida T, Sugiyam T, Okuno S, et al.: Relationship between blood pressure measurement and medication adherence and name recognition of antihypertensive drugs. Hypertens Res 2000, 23:21–24. Patients who monitored their blood pressure at home were significantly more compliant than those who did not monitor their blood pressure at home, providing evidence that home blood pressure monitoring had a positive effect on antihypertensive compliance.

    Article  PubMed  CAS  Google Scholar 

  13. Ward HJ, Morisky DE, Lees NB, et al.: a clinic and communitybased approach to hypertension control for an underserved minority population: design and methods. am J Hypertens 2000, 13:177–183.

    Article  PubMed  CAS  Google Scholar 

  14. Dahlof B, Lindholm LH, Carney S, et al.: Main results of the losartan versus amlodipine (LOa) study on drug tolerability and psychological general well-being. J Hypertens 1997, 15:1327–1335.

    Article  PubMed  CAS  Google Scholar 

  15. Karlberg BE, Lins LE, Hermansson K: Efficacy and safety of telmisartan, a selective aT1 receptor antagonist, compared with enalapril in elderly patients with primary hypertension. J Hypertens 1999, 17:293–302.

    Article  PubMed  CAS  Google Scholar 

  16. Grimm RH, Grandits Ga, Cutler Ja, et al.: Relationship of quality-of-life measures to long-term lifestyle and drug treatment in the treatment of mild hypertension study. arch Intern Med 1997, 157:638–648.

    Article  PubMed  Google Scholar 

  17. Croog SH, Levine S, Testa Ma, et al.: The effects of antihypertensive therapy on the quality of life. N Engl J Med 1986, 314:1657–1664.

    Article  PubMed  CAS  Google Scholar 

  18. Ware JE, Snow KK, Kosinski M, et al.: SF-36 Health Survey Manual & Interpretation Guide. Boston: Nimrod Press; 1993.

    Google Scholar 

  19. Fletcher AE, Bulpitt CJ, Chase DM, et al.: Quality of life with three antihypertensive treatments. Cilazapril, atenolol, Nifedipine. Hypertension 1992, 19:499–507.

    PubMed  CAS  Google Scholar 

  20. Breed JGS, Ciampricotti R, Tromp GP: Quality of life perception during antihypertensive treatment: a comparative study of bisoprolol and enalapril. J Cardiovasc Pharmacol 1992, 20:750–755.

    Article  PubMed  CAS  Google Scholar 

  21. Yodfat Y, Bar-On D, Amir M, et al.: Quality of life in normotensives compared to hypertensive men treated with isradipine or methyldopa as monotherapy or in combination with captopril: the LOMIR-MCT-IL study. J Hum Hypertens 1996, 10:117–122.

    PubMed  CAS  Google Scholar 

  22. Battersby C, Hartley K, Fletcher AE, et al.: Quality of life in treated hypertension: a case-control community based study. J Hum Hypertens 1995, 9:981–986.

    PubMed  CAS  Google Scholar 

  23. Hjemdahl P, Wiklund IK: Quality of life on antihypertensive drug therapy: scientific end-point or marketing exercise? J Hypertens 1992, 10:1437–1446.

    PubMed  CAS  Google Scholar 

  24. Muller A, Montoya P, Schandry R, et al.: Changes in physical symptoms, blood pressure and quality of life over 30 days. Behav Res Ther 1994, 32:593–603.

    Article  PubMed  CAS  Google Scholar 

  25. Kullman S, Svardsudd K: Differences in perceived symptoms/ quality of life in untreated hypertensive and normotensive men. Scand J Prim Health Care 1990, Suppl 1:47–53.

    Google Scholar 

  26. Wiklund I, Halling K, Ryden-Bergsten T, et al.: Does lowering the blood pressure improve the mood? Quality of life results from the Hypertension Optimal Treatment (HOT) study. Blood Press 1997, 6:357–364.

    Article  PubMed  CAS  Google Scholar 

  27. Caro JJ, Speckman JL, Salas M, et al.: Effect of initial drug choice on persistence with antihypertensive therapy: the importance of actual practice data. Can J Med assoc 1999, 160:41–46. In a retrospective analysis of outpatient prescriptions, the authors found that persistence among drug classes differed, with diuretics reporting the lowest rates of persistence and aCE inhibitors reporting the highest. a lack of persistence was associated with changes in therapeutic regimens.

    CAS  Google Scholar 

  28. Weir MR, Maibach EW, Bakris GL, et al.: Implications of a health lifestyle and medication analysis for improving hypertension control. arch Intern Med 2000, 160:481–490. Researchers identified four types of patients ranging from those with high adherence rates to medication and healthy behaviors to those with poor healthy behaviors and low adherence rates. Patients most likely to adhere to prescribed regimens had better health outcomes. This study highlights the necessity of individually tailoring hypertension management programs.

    Article  PubMed  CAS  Google Scholar 

  29. Schwartz LM, Woloshin S: Changing disease definitions: implications for disease prevalence. analysis of the third National Health and Nutrition Examination Survey, 1988–1994. Eff Clin Pract 1999, 2:76–85.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. AstraZeneca, LP, Health Economics and Outcomes Research, 725 Chesterbrook Boulevard, 19087-5677, Wayne, Pa, USA

    Teresa M. Zyczynski PharmD, MBa

  2. MEDTaP International, Inc., 7101 Wisconsin avenue, Suite 600, 20814, Bethesda, MD, USA

    Karin S. Coyne PhD, MPH

Authors
  1. Teresa M. Zyczynski PharmD, MBa
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  2. Karin S. Coyne PhD, MPH
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Zyczynski, T.M., Coyne, K.S. Hypertension and current issues in compliance and patient outcomes. Curr Hypertens Rep 2, 510–514 (2000). https://doi.org/10.1007/s11906-996-0034-7

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  • DOI: https://doi.org/10.1007/s11906-996-0034-7

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