Adherence to antihypertensive medication in the older hypertensive patients: the role of blood pressure measurement assistance

Author(s): Elena N Nalotova, Michail M Alesinskiy, Alexander E. Berezin & Sergey V Nalotov

Aim: To evaluate the compliance of patients with hypertension retirement age recommended antihypertensive drug therapy, to develop methods of its increase in the outpatient treatment and medical supervision to ensure the effectiveness of treatment Methods: One hundred fourteen older persons with documented mild-to-moderate hypertension were enrolled in the study. Office blood pressure (BP) was measured at the visit of the patents in the office by physician using sphygmomanometer “OMRON” (Japan) accordingly conventional technique. Morisky Medication Adherence Scales (MMAS)-4 was used to measure the adherence to antihypertensive drugs at baseline and within 8 weeks. Education assistance regarding use of conventional methods for life style modification, selfmeasurement of blood pressure and regular exposure of antihypertensive remedies was driven within 6 weeks after baseline. All subjects have completed diary to control of BP at home within treatment course and they have opportunity to contact with the physician when needed. Results: All enrolled hypertensive subjects were predominantly female (51.8%) and have exhibited mean age equal 67.3 years. At least 26% of patient population were smokers, 25% of individuals were obese. Diabetes and metabolic syndrome were defined 14% and 14% respectively, and antidiabetic drug (metformin) was given 4% of the patients in the entire group. Accordingly Morisky Medication Adherence Scales 51.8% of the entire group patients have exhibited medium adherence to antihypertensive treatment and 48.2% have demonstrated low adherence to one. No any significant differences were found between both cohorts of the individuals at baseline. Morisky Medication Adherence Scale-4 at 8 week has significantly improved and exhibited the statistically significant increase of patient number with medium adherence to antihypertensive treatment and decrease of frequency of low adherence to remedy taking. Conclusion: we found that the assistance of the older patients to measure BP and analyse of the BP control state might improve sufficiently the adherence of the persons to antihypertensive treatment strategy.