Antihypertensive nonadherence commonplace

Hypertension (2017) 69:1113-1120

Two people in five do not adhere to antihypertensives, according to research from the University of Leicester. Indeed, one in seven do not take any of their antihypertensive.

The researchers used a sensitive analytical technique (high-performance liquid chromatography-tandem mass spectrometry) to measure levels of antihypertensives in the urine and serum in 676 patients, aged on average 55.8 years (48.5% male), from the UK. Of these, 41.6% showed total or partial nonadherence to antihypertensives. Moreover, 14.5% showed total nonadherence. Women were 65% more likely to be non-adherent than men.

Combination treatment is often needed to control blood pressure. However, each additional antihypertensive increased the likelihood of nonadherence by 85%. Indeed, 79.3% of patients taking at least six antihypertensives were non-adherent. Each 10-year rise in age reduced the risk of non-adherence by 33%. Being prescribed diuretics increased the risk by 65%. Indeed, diuretics were significantly more likely to be associated with poor adherence than the other four groups of antihypertensive.