Risk Factors for Nonadherence to Antihypertensive Treatment
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
Grantová podpora
MC_PC_13090
Medical Research Council - United Kingdom
PubMed
28461599
DOI
10.1161/hypertensionaha.116.08729
PII: HYPERTENSIONAHA.116.08729
Knihovny.cz E-zdroje
- Klíčová slova
- adherence, blood pressure, diuretics, hypertension, polypharmacy,
- MeSH
- adherence pacienta statistika a číselné údaje MeSH
- antihypertenziva terapeutické užití MeSH
- diuretika terapeutické užití MeSH
- hodnocení adherence k farmakoterapii * MeSH
- hodnocení rizik MeSH
- hypertenze diagnóza farmakoterapie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- prediktivní hodnota testů MeSH
- retrospektivní studie MeSH
- senioři MeSH
- sexuální faktory MeSH
- stupeň závažnosti nemoci MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
- Spojené království MeSH
- Názvy látek
- antihypertenziva MeSH
- diuretika MeSH
Nonadherence to antihypertensive treatment is a critical contributor to suboptimal blood pressure control. There are limited and heterogeneous data on the risk factors for nonadherence because few studies used objective-direct diagnostic methods. We used high-performance liquid chromatography-tandem mass spectrometry of urine and serum to detect nonadherence and explored its association with the main demographic- and therapy-related factors in 1348 patients with hypertension from 2 European countries. The rates of nonadherence to antihypertensive treatment were 41.6% and 31.5% in the UK and Czech populations, respectively. Nonadherence was inversely related to age and male sex. Each increase in the number of antihypertensive medications led to 85% and 77% increase in nonadherence (P<0.001) in the UK and Czech populations, respectively. The odds of nonadherence to diuretics were the highest among 5 classes of antihypertensive medications (P≤0.005 in both populations). The predictive model for nonadherence, including age, sex, diuretics, and the number of prescribed antihypertensives, showed area under the curves of 0.758 and 0.710 in the UK and Czech populations, respectively. The area under the curves for the UK model tested on the Czech data and for the Czech model tested on UK data were calculated at 0.708 and 0.756, respectively. We demonstrate that the number and class of prescribed antihypertensives are modifiable risk factors for biochemically confirmed nonadherence to blood pressure-lowering therapy. Further development of discriminatory models incorporating these parameters might prove clinically useful in assessment of nonadherence in countries where biochemical analysis is unavailable.
Citace poskytuje Crossref.org
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