Effect of medication adherence on blood pressure control and risk factors for antihypertensive medication adherence

Rationale, aims and objectivesWe aim to investigate a range of risk factors associated with medication adherence among Chinese hypertensive patients. We also aim to investigate the association between medication adherence and blood pressure control. MethodsA cross-sectional study was conducted among Chinese hypertensive patients in a comprehensive teaching hospital in Shanghai, China, using a validated scale, a self-designed questionnaire and patients' medical records. ResultsOf the 232 eligible participants, 61 (26.3%), 51 (22.0%) and 120 (51.7%) showed low, medium and high adherence, respectively. Adjusted for socio-demographic, clinical and patient-related factors, antihypertensive medication adherence was significantly associated with better systolic blood pressure control (P=0.001), whereas the association with diastolic blood pressure control was relatively weak (P=0.334). In the multivariate analysis, patients with longer duration of drug use [P=0.012, odds ratio (OR)=0.46, 95% confidence interval (CI) 0.25-0.84], combination of antiplatelet agents (0.002, 0.38, 0.20-0.71), less concerns of medical cost (0.001, 0.18, 0.02-0.51), more availability of professional guidance (0.002, 0.34, 0.17-0.66) and more availability of family support (0.036, 0.51, 0.27-0.96) were more likely to adhere to their drug regimens. ConclusionsThe rate of suboptimal medication adherence among Chinese hypertensive patients is quite high. Interventions could focus upon the risk factors to improve antihypertensive medication adherence in clinical practice.