Perception of uncontrolled blood pressure and non-adhrenece to anti-hypertensive agents in diabetic hypertensive patients

We assessed the association between adherence to antihypertensive drug treatment and patient's perception of uncontrolled blood pressure (BP) in diabetic hypertensive subjects. This was a cross-sectional study that evaluated adherence to antihypertensives (Morisky questionnaire), patients'...

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Detalles Bibliográficos
Autores: Ledur, Priscila dos Santos, Leiria, Liana Farias, Severo, Mateus Dornelles, Silveira, Denise Tolfo, Massierer, Daniela, Becker, Alexandre Dalpiaz, Aguiar, Fernanda Musa, Gus, Miguel, Schaan, Beatriz D'Agord
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:Brasil
Institución:Universidade Federal do Rio Grande do Sul (UFRGS)
Repositorio:Repositório Institucional da UFRGS
Idioma:inglés
OAI Identifier:oai:www.lume.ufrgs.br:10183/239245
Acceso en línea:http://hdl.handle.net/10183/239245
Access Level:acceso abierto
Palabra clave:Diabetes mellitus
Hipertensão
Adesão à medicação
Diabetes mellitus;
hypertension
medication adherence
Descripción
Sumario:We assessed the association between adherence to antihypertensive drug treatment and patient's perception of uncontrolled blood pressure (BP) in diabetic hypertensive subjects. This was a cross-sectional study that evaluated adherence to antihypertensives (Morisky questionnaire), patients' perception of abnormal BP, office BP, and ambulatory BP monitoring in diabetic hypertensive subjects. We evaluated 323 patients, 65.2% women, aged 56.5 ± 7 years, glycosylated hemoglobin (HbA1c) 8.0% (range, 6.9%–9.6%), diabetes duration of 10 years (range, 5–17 years). Adherence to drug treatment was 51.4%. Patients who reported hypertension-related symptoms (60.4%) had a lower level of adherence (P < .001). Non-adherence occurred four times more frequently in patients who reported hypertension-related symptoms (P < .001, adjusted for use of three or more anti-hypertensives, age, and duration of diabetes). Non-adherents had higher office diastolic BP (83.6 ± 11.9 vs. 79.8 ± 9.9; P = .003), but no difference between groups was observed considering systolic, diastolic, and mean BP evaluated by ambulatory BP monitoring. Low rates of adherence to antihypertensive drug treatment were observed in outpatient hypertensive diabetic subjects. Perception of uncontrolled BP levels was strongly and independently associated with non-adherence. Non-adherence determined repercussion on office BP that may have clinical implications in cardiovascular risk.