COMPLIANCE WITH ANTIHYPERTENSIVE THERAPY - RAISING THE BAR OF EXPECTATIONS

Recent advances in the effectiveness of antihypertensive therapies and the measurement of medication-taking behavior have raised the bar of expectations, both for patients and prescribing clinicians. This artic le reviews the principal findings and makes recommendations to improve pill taking among patients with hypertension. It summarizes several s tudies related to hypertension epidemiology, component behaviors contr ibuting to suboptimal compliance with prescribed antihypertensive medi cations, the direct and indirect costs of nonadherent behaviors, and m easures of pill-taking behavior. Based on this analysis, current level s of hypertension detection, treatment, and control remain suboptimal. Heuristics for adjusting antihypertensive regimens may be misleading and too simplistic. More than half of those patients failing to achiev e goal blood pressure display suboptimal compliance rather than an ina dequate regimen. In conclusion, there is a need for enhanced sophistic ation about medication-taking behavior, especially for hypertension, s o that more patients with this condition can fully benefit from effect ive treatments.