Impact of Non-Compliance with Antihypertensive Medication on Stroke Incidence

Abstract

Background: Hypertension is a major risk factor for stroke. Effective management of hypertension through medication adherence is crucial in preventing stroke events. However, non-compliance with antihypertensive medication remains a significant challenge, leading to adverse health consequences. Aim of the study: The aim of this study was to evaluate the impact of non-compliance with antihypertensive medication on stroke incidence. Methods: This descriptive cross-sectional study was conducted in Department of Medicine and Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh from March 2010 to August 2010. Total 120 patients who were diagnosed with stroke were selected for the study. Result: The majority of participants were aged 51-60 (35.8%) and the mean age was 54.6 years (SD 4.3). Males (57.5%) outnumbered females (42.5%), with a male-to-female ratio of 1.38:1. Age and sex distributions were significantly different (p < .001). Cerebral infarction was the most common stroke type (62.5%). Most participants (65.0%) were known hypertensive, with 11.7% newly diagnosed and 23.3% normotensive. Among hypertensive patients, non-compliance was high (71.8%). In hypertensive stroke patients, non-compliance was associated with higher rates of cerebral infarction (37.2% vs. 20.5%) and cerebral hemorrhage (33.3% vs. 6.4%). Subarachnoid hemorrhage and hemorrhagic transformation were rare. The overall Chi-square test was significant (p < .001). Recurrent stroke was more common in non-compliant patients (68.8% vs. 31.3%). The Chi-square test was significant (p < .001). Conclusion: Non-compliance was strongly associated with increased risk of both cerebral infarction and cerebral hemorrhage, underscoring the importance of consistent medication adherence.