Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2012;65:544-50 - Vol. 65 Num.06 DOI: 10.1016/j.rec.2012.01.020

Do Patients With High Vascular Risk Take Antihypertensive Medication Correctly? Cumple-MEMS Study

Emilio Márquez-Contreras a,b,, Mariano de la Figuera-Von Wichmann a,c, Josep Franch-Nadal a,d, Jose Luis Llisterri-Caro a,e, Vicente Gil-Guillén a,f, José Luis Martín-de Pablos a,b, José Joaquín Casado-Martínez a,b, Nieves Martell-Claros a,g

a Grupo de Trabajo sobre Cumplimiento e Inercia, Sociedad Española de HTA (SEH-LELHA), Madrid, Spain
b Unidad de Gestión Clínica La Orden, Huelva, Spain
c ABS Sardenya, Barcelona, Spain
d EAP Raval Sud and Unitat Suport a la Recerca-IDIAP, Barcelona, Spain
e Centro de Salud Benlloch, Valencia, Spain
f Universidad de Medicina, Alicante, Spain
g Servicio de Medicina Interna, Hospital San Carlos, Madrid, Spain

Keywords

Hypertension. High vascular risk. Compliance. Angiotensin-converting enzyme inhibitors. Angiotensin receptor blockers. Prospective study.

Abstract

Introduction and objectives

To assess compliance with treatment inhibit the renin-angiotensin system (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) in uncontrolled hypertension in patients at high cardiovascular risk.

Methods

Prospective, longitudinal, multicenter study, carried out in 102 Spanish primary care centers. We included 808 uncontrolled hypertensive patients treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers who were at high vascular risk; 4 visits were conducted: baseline and 1, 3, and 6 months later. Compliance was measured by electronic monitors. We calculated the mean percentage compliance, the overall percentage of compliers, once-daily compliers, compliers with the prescribed time frame, and antihypertensive coverage. We considered a patient to be a complier when the percentage compliance was 80%-100%.

Results

In all, 701 patients completed the study (mean age, 63.7 [11.1] years). The systolic and diastolic blood pressures decreased significantly (P<.0001) to 18.8mmHg and 9.8 mmHg, respectively. The control rate was 70% (95% confidence interval, 65.6%-74.4%) (P=.0001). The rate of control was significantly higher among compliers than noncompliers (P<.05). The mean percentage of doses taken was 87.9% (95% confidence interval, 84.8%-91%) and the mean therapeutic coverage was 82.4% (95% confidence interval, 78.7%-86.1%). Overall, 73.3% of the patients were compliers (95% confidence interval, 69%-77.6%), 52.8% (95% confidence interval, 48%-57.6%) were once-daily compliers, and 46.5% (95% confidence interval, 41.9%-51.1%) complied with the prescribed time frame. Noncompliance was associated with a higher number of drugs prescribed (P<.001).

Conclusions

In hypertensive patients at high vascular risk, the rate of therapeutic noncompliance was very high, mainly when they took 5 or more pills daily.

1885-5857/© 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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