Journal of General Internal Medicine

, Volume 2, Issue 5, pp 298–305

The effect of medication compliance on the control of hypertension


  • Seth A. Eisen
    • Health Services Reserach and Development ServiceSt. Louis Veterans Administration Medical Center
    • the Department of MedicineWashington University School of Medicine
  • Robert S. Woodward
    • Health Administration ProgramWashington University School of Medicine
  • Douglas Miller
    • Department of MedicineSt. Louis University School of Medicine
  • Edward Spitznagel
    • Department of Preventive Medicine and Public Health, Division of BiostatisticsWashington University School of Medicine
  • Cynthia A. Windham
    • Department of PsychiatryWashington University School of Medicine
Original Articles

DOI: 10.1007/BF02596162

Cite this article as:
Eisen, S.A., Woodward, R.S., Miller, D. et al. J Gen Intern Med (1987) 2: 298. doi:10.1007/BF02596162


The effect of medication-taking patterns on blood pressure was investigated in 24 hypertensive outpatients being treated with once-daily doses of hydrochlorothiazide or chlorthalidone. Medication-taking patterns were measured with a small pill dispenser that electronically records the time of medication removal. Blood pressure reduction was found to correlate better with the total number of doses the patient removed from the pill pack during a month than with any of four other compliance measures that were based on the timing of dose removal. Analysis also suggested that blood pressure is improved if patients ingest omitted doses to “catch up” to the prescribed regimen. It is concluded that a simple pill count may be the most clinically relevant definition of compliance for patients with hypertension being treated with only hydrochlorothiazide or chlorthalidone, and that such patients should ingest all prescribed doses, regardless of the time interval between doses.

Key words

medication compliancehypertensionhydrochlorothiazidechlorthalidone

Copyright information

© Society of General Internal Medicine 1987