O44 LOW ADHERENCE TO HYPERTENSION MANAGEMENT IN THE COLOMBIAN COMMUNITY IMPLEMENTATION RE-HOPE STUDY

Abstract

Background and objective: Uncontrolled hypertension is a leading cause of death worldwide, and it's associated with a high socioeconomic burden. Demographic, social, behavioral, and health system-related factors contribute to low adherence to hypertension management. Recognizing adherence rates is a mainstay for improving hypertension control. This study examined the level of adherence to hypertension management and control in the participants belonging to the implementation, integration, and institutionalization of a community-based care strategy to reduce the risk of cardiovascular disease in Santander (ReHOPE) study. Methods This cross-sectional analysis was conducted in 12 municipalities of Santander, Colombia, from May to December 2023. Participants over 18 with hypertension, not in a cardiovascular risk program, were included. Data were collected door-to-door by trained community health providers using standardized questionnaires for socio-demographic information, medication use, lifestyle details, and hypertension knowledge. Physical exams provided anthropometric and blood pressure values. Medication adherence was assessed with the Morisky 4-item scale. Continuous variables are presented as central tendency measures, and categorical variables as frequencies and proportions. Analysis was performed using R software. Results: A total of 2,617 participants were included. The mean age was 65.09 (SD 12.09), and 64.3% were women. The mean systolic blood pressure was 133.94 mmHg (SD 16.53). The median waist-to-hip ratio (WHR) was 0.96 (IQR 0.92-1.00) in men and 0.91 (IQR 0.87-0.96) in women. Among participants, 33.9% had uncontrolled hypertension, 28.5% were not aware of their condition, and 69.2% reported no physical activity. High WHR was found in 84.8% of the participants. Antihypertensive monotherapy use was reported in half of the participants (53.8%). The most frequently used pharmacological group was angiotensin-converting enzyme inhibitors (81.8%). Hypertension control was observed in 66.1%, and 12.6% had high adherence. Conclusions: Low medication adherence was observed, only 12.6% of participants reported high adherence and nearly 40% had uncontrolled hypertension. Additionally, nearly 30% were undetected by the healthcare system. Thus, improving medication adherence and healthcare strategies is essential to enhance health outcomes.