Adherence to Antihypertensive Medications and Some of Its Clinical Implications in Patients Seen At a Tertiary Hospital in Nigeria

Abstract

Abstract: Background: Adherence to antihypertensive is crucial to treatment success in subjects with hypertension. This study is aimed at assessing antihypertensive drug adherence using validated tool and its relationship with some demographic and clinical parameters in outpatient hypertensive subjects. Methods:The Morisky Medication Adherence Scale (MMAS-4) was used to assess drug adherence status in 150 hypertensive patients who were consecutively recruited in a Medical Outpatient Department of a Tertiary Health Centre. All the patients had resting 12- lead electrocardiogram (ECG) done to determine left ventricular hypertrophy (LVH). Data were analyzed with SPSS 13 and statistical significance of p< 0.05 was used. Results: One hundred and fifty hypertensive patients with a mean age of 61.53± 9.72years were recruited over a period of 6 months. Sixty seven (44.7%) were good drug adherers while 55.3% were not. Patients with poor antihypertensive adherence had higher Sokolow- Lyon ECG score (34.46 ± 7.87 vs. 22.96 ± 7.07; p= 0.07) as well as longer P wave duration on ECG (0.15 ± 0.03 vs. 0.12± 0.04; p= 0.03). There was higher rate of ECG LVH among patients with poor drug adherence (47.0%) compared to patients with good drug adherence (4.5%). Significant correlates of poor drug adherence were age (r= - 0.221; p=0.022) and BMI (r= 0.431; P<0.001). Conclusion:The rate of poor drug compliance was high with preponderance of LVH in poor adherer. Physicians will do well to engage their hypertensive patients on hypertension and its treatment with a view to improving drug adherence in them. Keywords: Medication, adherence, hypertension, electrocardiogram