Association between medication adherence and blood pressure control in urban hypertensive patients in central India

Introduction: Cardiovascular and renal complications associated with hypertension (HTN) can be reduced if blood pressure (BP) is well controlled. However, a large percentage of patients fail to achieve target BPs, largely due to poor medication adherence. We conducted a cross-sectional study of patients of HTN to assess patient adherence to treatment and the association between medication adherence and BP control. Methodology: The study was a cross-sectional survey of adult hypertensive patients of either sex who had been on antihypertensive therapy for the past 3 months. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Level of control of BP was evaluated using the BP goals recommended by the Eighth Joint National Committee (JNC-8). Results: Out of a total of 200 patients, only 29.5% of patients had achieved their target BP as per JNC-8 recommendations after a minimum of 3 months of antihypertensive therapy. The average adherence score on the MMAS-8 was 6.47 (±1.8). A high adherence was found in 39% of patients, while 32.5% of HTN patients had a medium score and 28.5% had low adherence scores. There was a significant correlation between medication adherence and BP control. Only 1.5% of patients with low adherence score and 11.5% with medium score had achieved their target BP while 16.5% with high had done so. Conclusion: Higher medication adherence scores were associated with better BP control. However, the percentage of patients with controlled HTN on treatment was low as was the proportion of patients with a high medication adherence score.