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(Hypertension. 2005;46:255.)
© 2005 American Heart Association, Inc.

Editorial Commentaries

Noncardiovascular Illness as Barrier to Antihypertensive Treatment

Jan A. Staessen; Lutgarde Thijs; Willem H. Birkenhäger

From the Study Coordinating Centre, Hypertension Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Belgium (J.A.S., L.T.); and Erasmus University, Rotterdam, the Netherlands (W.H.B.).

Correspondence to Jan A. Staessen, Study Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000, Leuven, Belgium. E-mail jan.staessen@med.kuleuven.be

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Control rates of hypertension vary from one country to another, but in general, they are much lower than would be desirable. In the United States, the National Health and Nutrition Examination Survey¹ showed that the awareness of the hypertensive population improved from 50% in the 1970s to 70% in the 1990s. Over the same time interval, the proportion of treated hypertensive patients with normalized blood pressure rose from 10% to 29%. Recent studies in Europe² and other parts of the world³ confirmed that the rule of halves still exists and that the fractions of hypertensive patients with properly controlled blood pressure range from 5% to 45%.^4,5 Patients with high blood pressure not carrying out recommended therapy is a pervasive phenomenon that contributes worldwide to the low control rates of hypertension.

Adherence, in a more judgmental way, also termed compliance, is the extent to which a patient’s behavior coincides with the clinical prescription.⁶ It usually increases with higher education, affluence, social support, and the frequency and quality of the interactions with the care providers, but it diminishes with the number of tablets to be taken.⁷ Other frequently cited reasons for not filling prescriptions are the fear that antihypertensive drugs cause side effects and the misconception that hypertension, a silent condition, carries little risk.⁶ Here, the article by Wang et al⁸ breaks new grounds. Using a retrospective cohort design, they studied 51 517 patients 65 years of age who were enrolled in the Pennsylvania Pharmaceutical Contract for the Elderly Program (PACE). These . . . [Full Text of this Article]

Related Article:

Effects of Noncardiovascular Comorbidities on Antihypertensive Use in Elderly Hypertensives

Philip S. Wang, Jerry Avorn, M. Alan Brookhart, Helen Mogun, Sebastian Schneeweiss, Michael A. Fischer, and Robert J. Glynn
Hypertension 2005 46: 273-279. [Abstract] [Full Text] [PDF]

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				Is Noncardiovascular Comorbidity a Risk Factor for Antihypertensive Nonadherence? Journal Watch Cardiology, September 30, 2005; 2005(930): 3 - 3. [Full Text]