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Adherence to Antihypertensive Medications: Current Status and Future Directions

  • Hypertension (S Taler, Section Editor)
  • Published:
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Abstract

Elevated blood pressure (BP) accounts for the largest global proportion of disease burden and is largely treatable through the use of antihypertensive medications. Adherence to antihypertensive medication may be defined as the extent to which patient behavior coincides with recommendations agreed upon by the health-care provider and the patient and encompasses initiation, implementation, and discontinuation. Despite the proven clinical efficacy of antihypertensive medications to control BP, approximately half of treated patients are nonadherent. Nonadherence to antihypertensive medications is a multifactorial concern. Barriers to antihypertensive medication adherence are numerous and include patient-related (e.g., beliefs about medication, motivation, mental health), provider-related (e.g., patient-provider communication, failure to appropriately escalate treatment), therapy-related (e.g., an asymptomatic disease, side effects, complexity of regimens), and system-related (e.g., medication cost, health literacy, uncoordinated delivery of services) influences. Several techniques to improve adherence to antihypertensive medications have been identified, with sufficient supporting evidence from randomized trials to inform clinical practice recommendations. This review summarizes the current understanding of the prevalence and impact of the failure to adhere to the medical management of hypertension. Factors linked to improved adherence and studies that assessed strategies to improve adherence are also summarized.

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Conflict of Interest

Ross Feldman has no conflicts of interest. Kim Lavoie worked as a consultant for Abbvie, Takeda, Boehringer Ingelheim, and Kataka Medical Communication. Lavoie received a grant from Abbvie; payment for a motivational communication program for Canadian Dermatology Association; and payment for motivational communication programs for Kataka Medical Communication.

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Authors and Affiliations

  1. Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada

    Joshua A. Rash & Tavis S. Campbell

  2. Department of Psychology, University of Quebec at Montreal (UQAM), CP 8888 Succursale Centre Ville, Montreal, QC, H3C 3P8, Canada

    Kim L. Lavoie

  3. Montreal Behavioral Medicine Centre (MBMC), Research Centre, Hopital du Sacre-Coeur de Montreal, 5400 Gouin Blvd West, J-3145, Montreal, QC, H2J 1C5, Canada

    Kim L. Lavoie

  4. Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5C1, Canada

    Ross D. Feldman

Authors
  1. Joshua A. Rash
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  2. Kim L. Lavoie
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  3. Ross D. Feldman
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  4. Tavis S. Campbell
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Corresponding author

Correspondence to Ross D. Feldman.

Additional information

This article is part of the Topical Collection on Hypertension

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Rash, J.A., Lavoie, K.L., Feldman, R.D. et al. Adherence to Antihypertensive Medications: Current Status and Future Directions. Curr Cardiovasc Risk Rep 8, 415 (2014). https://doi.org/10.1007/s12170-014-0415-4

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  • DOI: https://doi.org/10.1007/s12170-014-0415-4

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