Poor compliance with treatment is believed to be the most frequent reason why many patients with high blood pressure (hypertension) do not respond to drug treatment. However, a study in this week's BMJ finds no difference in compliance between treatment resistant and treatment responsive patients.
Researchers at the University Hospital in Basle, Switzerland identified 103 patients with hypertension who had been taking between two and four drugs for at least one month. Using electronic pill boxes that record every opening, they monitored whether patients took their medication over four weeks. (Patients who took 80% or more of their prescribed doses were considered to be compliant).
No difference in compliance was found. Forty (82%) of the 49 treatment resistant patients were compliant, while 46 (85%) of the 54 patients responsive to treatment were compliant.
These findings challenge the common assumption that non-compliance with treatment occurs more in patients not responsive to antihypertensive drugs, say the authors. They suggest that other factors should be examined to explain treatment resistance.
Edouard Battegay, Assistant Professor of Internal Medicine, University Hospital, Basle, Switzerland
Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study BMJ Volume 323, pp 142-146