IJCS | Volume 33, Nº3, May / June 2020

DOI: https://doi.org/10.36660/ijcs.20190069 272 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2020; 33(3):272-277 Mailing Address: Walter Espeche General Interzonal Hospital Specialized in Acutes San Martin - Clinica Medica - 1 y 70, La Plata, B1904CFU - Argentina E-mail: wespeche@gmail.com Analysis of Adherence to Antihypertensive Drug Treatment in an Argentinean Cohort Walter Gaston Espeche, 1 R odrigo Sabio, 2 Alejandro Diaz, 3 R oberto Parodi, 4 C arlos Enrique Leiva Sisnieguez, 5 R oberto Antonio Flores, 6 Silvia Poppe, 7 Javier Altube, 2 Diego Grimaldi, 2 Martin Rogelio Salazar 5 Interzonal General Hospital of Acutes Jose de San Martin, 1 Buenos Aires - Argentina Hospital Calafate, 2 Santa Cruz - Argentina CONICET Tandil, 3 Buenos Aires - Argentina Universidad Nacional de Rosario, 4 Rosario - Argentina Hospital Interzonal General de Agudos General San Martin, 5 La Plata - Argentina Hospital de Santiago del Estero, 6 Santiago del Estero - Argentina Hospital General de Agudos Juan A Fernandez, 7 Buenos Aires - Argentina Manuscript received April 05, 2019; revised manuscript August 05, 2019; accepted August 27, 2019. Abstract Background: Adherence to antihypertensive medication is a major challenge in the management of hypertension, and non-adherence is an important barrier to effective management of hypertension. Objectives: To determine the adherence rate to hypertensive drug treatment and the factors that influence non- adherence in a cohort of the Argentinean population. Methods: A multicenter cross-sectional study was conducted in eight cities of Argentina. Consecutive hypertensive patients seen in general practice offices, receiving pharmacological treatment for at least six months were included. Blood pressure measurements were performed by physicians during the patient visit. The level of adherence was assessed using the Morisky questionnaire, and patients were divided into non-adherent and adherent. Continuous variables were compared using independent t-test. Categorical variables were compared using the χ 2 test. To identify the variables independently associated with non-adherence, a forward stepwise binary regression logistic model was performed, and the results expressed as odds ratio (OR) with 95% of confidence interval. All tests were two-tailed, and p-values < 0.05 were considered statistically significant. Results: A total of 852 individuals (52% women, 62 ± 13 years) were included. The main reason for lack of adherence was forgetfulness of medication intake and errors in the time of intake (~ 40% in both). Individuals with more cardiovascular risk factors (smoking, diabetes, dyslipidemia and previous cardiovascular events) had lower adherence to antihypertensive treatment, and considerably younger (~ five years younger). Conclusions: Adherence rate to antihypertensive drug treatment in our study group was higher than the one reported in previous studies, and the main reason for non-adherence was forgetfulness of medication intake. (Int J Cardiovasc Sci. 2020; 33(3):272-277) Keywords: Hypertension/epidemiology; Risk Factors; Antihypertensive Agents; Cross-Sectional Study. Introduction Hypertension contributes to the global burden of cardiovascular disease and premature morbidity and mortality. 1 The ability of pharmacological treatment of hypertension to reduce the risk of cardiovascular events and decrease morbidity and mortality is well established. 2,3 Adherence to antihypertensive medication is a major challenge that clinicians often face in the management of hypertension. 4 Moreover, non-adherence is the main obstacle to controlling hypertension in the community and a significant barrier to an effective management. 5-7 Good adherence is therefore crucial to improve hypertension control rates and prevent complications such as stroke, coronary artery disease, aneurysms and heart failure. 8,9