Treated hypertensives with good medication compliance are still in a state of uncontrolled blood pressure in the Japanese elderly
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Blood pressure (BP) is poorly controlled in many countries. Poor compliance was suggested as the main cause for poor BP control. The purpose of this study was to examine the association between compliance and the control of both casual blood pressure (BP) and 24-hr ambulatory BP in a Japanese elderly population.
The study was a cross-sectional survey. Casual BP and 24-hr ambulatory BP were measured at home. Hypertension was defined as casual systolic BP (SBP)≧140 and/or diastolic BP (DBP)≧90 mmHg, or as treated hypertension. A compliance rate of greater than 80% by the pill count method was defined as good compliance.
Of the 178 treated hypertensives, 82.6% showed good compliance. Between the treated hypertensives with good compliance and those with poor compliance, no significant difference was found in either casual BP or ambulatory BP. Of the treated hypertensives with good compliance, the prevalence of achieved target ambulatory BP, i.e., daytime BP<135/85 mmHg, nighttime BP<120/75 mmHg, and 24-hr BP<125/80 mmHg, was, respectively, 35.4%, 43.5%, and 20.4%.
Casual BP and 24-hr ambulatory BP were poorly controlled in the community-living elderly although many of the treated hypertensives showed good compliance. It is unlikely that this inadequate control of hypertension is due to poor compliance on the part of the subjects.
- Du X, Cruickshank K, McNamee R, Sarace M, Sourbutts J, Summers A, Roberts N, Walton E, Holmes S. Case control study of stroke and the quality of hypertension control in northwest England. BMJ 1997; 314: 272–276.
- Krumholz HM, Parent EM, Tu N, Vaccarino V, Wang Y, Radford MJ, Hennen J. Readmission after hospitalization for congestive heart failure among medicare beneficiaries. Arch. Intern. Med. 1997; 157: 99–104. CrossRef
- Neaton JD, Grimm RH Jr, Prineas RJ, Stamler J, Grandits GA, Elmer PJ, Cutler JA, Flack JM, Schoenberger JA, McDonald R, et al. Treatment of mild hypertension study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA 1993; 270: 713–724. CrossRef
- The fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Arch. Intern. Med. 1993; 153: 154–183. CrossRef
- Journal of Health and Welfare Statistics. Health and Welfare Statistics Association, Tokyo, 1998; 45: 81–88.
- World Health Organization. Hypertension control. Geneva: World Health Organization. Tech. Rep. Ser. 1996: 863.
- Journal of Health and Welfare Statistics. Health and Welfare Statistics Association, Tokyo, 1998; 45: 101–111.
- Hansson L. The benefits of lowering elevated blood pressure: a critical review of studies of cardiovascular morbidity and mortality in hypertension. J. Hypertens. 1996; 14: 537–544. CrossRef
- MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J. Blood pressure, stroke, and coronary heart disease. Part I: Prolonged differences in blood pressure. Prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–774. CrossRef
- Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke, and coronary heart disease. Part 2: Shortterm reduction in blood pressure. Overview of randomized drug trials in their epidemiological context. Lancet 1990; 355: 827–838. CrossRef
- Coca A. Actual blood pressure control: are we doing things right? J. Hypertens. 1998; 16 (suppl 1): S45-S51.
- Hosie J, Wiklund I. Managing hypertension in general practice: can we do better? J. Hum. Hypertens. 1995; 9: S15-S18.
- Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, Horan MJ, Labarthe D. Prevalence of hypertension in the US adult population. Results from the third national health and nutrition examination survey, 1988–1991. Hypertens. 1995; 25: 305–313.
- Jackson R. What are the implications for the community of the discrepancy between theory and practice of BP control? J. Hum. Hypertens. 1995; 9 (suppl 2): S25-S28.
- Mancia G, Sega R, Milesi C, Cesana G, Zanchetti A. Blood pressure control in the hypertensive population. Lancet 1997; 349: 454–457. CrossRef
- Col N, Fanale J, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch. Intern. Med. 1990; 150: 841–845. CrossRef
- Urqhuart J. Role of patient compliance in clinical pharmacokinetics. A review of recent research. Clin. Pharmacokinet 1994; 27: 202–215.
- Waeber B, Burnier M, Brunner HR. Compliance with antihypertensive therapy. Clin. Exp. Hypertens. 1999; 21 (5–6): 973–985.
- Perloff D, Sokotow M, Cowan R. The prognostic value of ambulatory blood pressure. JAMA 1983; 249: 2792–2798. CrossRef
- White WB, Schulman P, McCabe EJ, Dey HM. Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension. JAMA 1989; 261: 873–877. CrossRef
- The sixth report of the Joint National Committee on Prevention, Detection Evaluation, and Treatment of High Blood Pressure. Arch. Intern. Med. 1997; 157: 2413–2446.
- Kahn RL, Miller NE. Assessment association of altered brain function in the aged. In: Storandt M, Siegler IC, Elias MF (eds). The clinical psychology of aging. Plenum, New York. 1978.
- Imai Y, Sasaki S, Minami N, Munakata M, Hashimoto J, Sakuma H, Sakuma M, Watanabe N, Imai K, Sekino H, et al. The Accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure monitoring device based on the cuffoscillometric method and the korotokoff sound technique. Am. J. Hypertens. 1992; 5: 719–726.
- 1999 a World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension: Guideline Subcommittee. J. Hypertens. 1999: 17: 151–183.
- Okuno J, Yanagi H, Tomura S, Oka M, Hara S, Hirano C, Tsuchiya S. Compliance and medication knowledge among elderly Japanese home-care recipients. Eur. J. Clin. Pharmacol. 1999; 55: 145–149. CrossRef
- Nuesch R, Schroeder K, Dieterle T, Martina B, and Battegay E. Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study. BMJ 2001; 323: 142–146. CrossRef
- Muratani H, Fukiyama K, Kamiyama T, Kimura Y, Abe K, Ishii M, Fujii J, Kuwajima I, Shiomi T, Kawano Y, Mikami H, Ibayashi S, Omae T. Current status of antihypertensive therapy for elderly patients in Japan. Hyperten. Res. 1996; 19: 281–290. CrossRef
- Hanson L, Zanchetti A. The Hypertension Optimal Treatment (HOT) Study: randomization, risk profiles and early blood pressure results. Blood Press. 1994; 3: 322–327. CrossRef
- Berlowitz DR, Ash AS, Hickey EC, Friedman RH, Glickman M, Kader B, Moskowitz MA. Inadequate management of blood pressure in a hypertensive population. N. Engl. J. Med. 1998; 339: 1957–1963. CrossRef
- Hyman DJ, Pavlik VN. Self-reported Hypertension treatment practices among primary care physicians. Blood pressure thresholds, drug choices, and the role of guidelines and evidence-based medicine. Arch. Intern. Med. 2000; 160: 2281–2286. CrossRef
- Hiwada K, Ogihara T, Matsumoto M, et al. Guidelines for Hypertension in the Elderly.—1999 Revised Version—Hyperten. Res. 1999; 22: 61–63. CrossRef
- Cruickshank JM, Thorp JM, Zacharias FJ. Benefits and potential harm of lowering high blood pressure. Lancet 1997; 1: 581–584.
- Staessen J, Bulpitt C, Clement D, De Leeuw P, Fagard R, Fletcher A, Forette F, Leonetti G, Nissinen A, O’Malley K, et al. Relationship between mortality treated blood pressure in elderly patients with hypertension: report of the European Working Party on High blood pressure in the elderly. BMJ 1989; 298: 1552–1556. CrossRef
- Treated hypertensives with good medication compliance are still in a state of uncontrolled blood pressure in the Japanese elderly
Environmental Health and Preventive Medicine
Volume 7, Issue 5 , pp 193-198
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- blood pressure control
- poor compliance
- community-living elderly
- ambulatory blood pressure monitoring
- physician’s attitude