gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Drug regimen compliance in uncontrolled hypertension

Medikamenten-Compliance bei unkontrollierter Hypertonie

Meeting Abstract (Hypertonie 2003)

  • presenting/speaker T. Mengden - Aardex (Bonn, D)
  • S. Uen - Aardex (Bonn, D)
  • E. Tousset - Aardex (Bonn, D)
  • R. Düsing - Aardex (Bonn, D)
  • H. Vetter - Aardex (Bonn, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochV38

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2003/03hoch038.shtml

Published: November 11, 2004

© 2004 Mengden et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objectives

To compare drug regimen compliance (DRC) in hypertensives treated with combination therapy whose blood pressures (BP) are controlled vs uncontrolled after 4 weeks of self-monitored BP measurement. To observe the consequences in uncontrolled patients of switching one drug of the combination therapy to candesartan/HCTZ with and without a compliance intervention program.

Methods

Self- and ambulatory-monitoring of BP were done with validated upper arm oscillometric devices. Patients' dosing histories were compiled electronically (MEMS(c), AARDEX).

Results

Patients with BP >140/90 mmHg despite combination therapy were begun on MEMS monitoring and self BP measurement for 4 weeks of run-in. Of 62 such patients, 18 of 61 (29.5%) evaluable patients were normotensive at 4 weeks (Group A); in the remaining 43 still uncontrolled patients, candesartan/HCTZ was substituted for one of the combination therapy drugs, with half these patients receiving passive compliance monitoring (B) and half a DRC intervention program (C). All groups were then followed for 8 weeks. DRC before week 4 was significantly higher in A than in the uncontrolled patients (B&C). DRC was stable during run-in in A, but declined in B and C. After the change to candesartan/HCTZ in B&C, systolic BP was significantly reduced (p<0.04 in B, p<0.01 in C, week 12 vs 4). DRC after week 4 was not different in the three groups and stayed constant over time. DRC during weekends was lower than during weekdays in all groups.

Conclusions

Normalization of BP was associated with superior drug regimen compliance in previously uncontrolled patients treated with a combination drug regimen. Switching still-uncontrolled patients to candesartan/HCTZ significantly reduced systolic BP and stabilized a declining DRC. Further study is needed to determine the time-period in the patient's antecedent drug dosing history when DRC has its greatest influence on present BP, and the role of poor DRC on weekends.