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.