Factors related to poor control of blood pressure with antihypertensive drug therapy

Objectives: To study the associations of patient-related and perceived healthcare-related factors with the control of blood pressure. Subjects: Physicians identified all of the hypertensive patients they saw during 1 week in 26 health centres. Out of 2219 patients, 80% agreed to participate, 88% of which took antihypertensive medication. Methods: In this cross-sectional questionnaire study, based on 82 opinion statements, 14 problem indices were formed using factor analysis. Logistic regression models were used to study the associations with blood pressure control. Results: Eighty per cent of the men and 79% of the women had poor blood pressure control (BP greater than or equal to140/90 mmHg). High levels of hopelessness towards hypertension (adjusted OR 2.16; 95% confidence interval (CI) 1.20-3.88) as well as medium and high levels of frustration with treatment (adjusted OR 1.50; 95% CI 1.04-2.18 and OR 1.83; 95% CI 0.98-3.44) were associated with poor control. The perceived tension with blood pressure measurement (adjusted OR 1.60; 95% CI 1.08-2.36) was similarly associated with poor control. Non-compliance in men, old age and monotherapy were also associated with poor blood pressure control. Conclusion: Hopelessness, frustration with treatment, and perceived tension with blood pressure measurement are associated with poor blood pressure control.