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Patient adherence and the treatment of hypertension

Norman M Kaplan, MD
Section Editor
George L Bakris, MD
Deputy Editor
John P Forman, MD, MSc


The latest National Health and Nutrition Examination Survey (NHANES) found that about 74 percent of hypertensive patients in the United States are being treated, and 72 percent of those being treated have their blood pressure well controlled (which was defined as a pressure below 140/90 mmHg) (table 1) [1,2].

An important reason for this shortfall is lack of patient adherence with therapy, although this is difficult to ascertain [3,4]. This problem persists even though individual programs have shown excellent adherence to and results from both non-drug [5] and drug regimens [6].

This topic will review the major issues related to nonadherence with antihypertensive therapy. A more complete discussion of noncompliance is discussed elsewhere. (See "Compliance with lipid altering medications and recommended lifestyle changes".)


Nonadherence to antihypertensive medication is common. As an example, in a study of 149 hypertensive patients who were monitored with electronic pill boxes, 42 percent were nonadherent, defined as taking less than 80 percent of prescribed antihypertensive medication [7]. In patients with hypertension, many factors have been found to reduce adherence (table 2).

Patient and disease characteristics — Patients with hypertension have special problems related to the nature of their disease.


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Literature review current through: Sep 2016. | This topic last updated: Aug 2, 2016.
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