Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study

Objectives To prospectively compare compliance with treatment in patients w ith hypertension responsive to treatment versus patients with treatment res istant hypertension. Design Prospective case control study. Setting Outpatient department in large city hospital in Switzerland, provid ing primary, secondary, and tertiary care. Participants 110 consecutive medial outpatients with hypertension and takin g stable treatment with at least two antihypertensive drugs for at least fo ur weeks. Main outcome measures Treatment compliance assess with MEM devices; blood p ressure determined by 12 hour daytime ambulatory monitoring (pressure <135/ 85 mm Hg in patients age <less than or equal to>60 years and <155/90 mm Hg in patients aged >60 indicated hypertension responsive to treatment). Results Complete data were available for 103 patients, of whom 86 took grea ter than or equal to 80% of their prescribed doses ("compliant") and 17 too k <80% ("non-compliant"). Of the 49 patients with treatment resistant hyper tension, 40 (82%) were compliant, while 46 (85%) of the patients responsive to treatment were compliant. Conclusion Non-compliance with treatment was not more prevalent in patients with treatment resistant hypertension than in treatment responsive patient s.