Compliance with antihypertensive therapy after renal artery stenting.
Hypertension is an important clinical endpoint after renal artery revascularization for renal artery stenosis (RAS). Medication compliance is a critical determinant of blood pressure control. Although factors influencing compliance are known in essential hypertension, they have not been evaluated in studies investigating renal artery revascularization. The aim of this study was to assess the determinants of compliance to antihypertensive therapy in patients with RAS following renal artery stent placement (RASP). A cross-sectional study evaluating blood pressure, antihypertensive medications, quality of life, compliance, and determinants of compliance to antihypertensive therapy was undertaken in 112 patients undergoing RASP. Additionally, cardiovascular risk factors, antihypertensive medications, and cardiovascular history were reported. Self-reported compliance was 79% +/- 24% (scale of 0% [none] to 100% [complete] compliance) in patients after RASP. Determinants of compliance by multivariate analysis included physical symptoms, which correlated negatively to compliance and included loss of appetite (r2 = 0.26, P < 0.0001), dizziness (r2 = 0.06, P < 0.01), and cough (r2 = 0.03, P < 0.05). Systolic blood pressure correlated positively with compliance (r2 = 0.03, P < 0.05). The number or class of antihypertensive medications did not influence compliance. Patients' physical symptoms and level of systolic blood pressure, rather than the number or class of medications, influence compliance in patients with continued hypertension after RASP. Attention to physical symptoms may help to improve blood pressure control in this population.
Reddy
Bhagat K
BK
Department of Medicine, Medical College of Ohio, Toledo, OH 43614-2598, USA.
Kennedy
David J
DJ
Colyer
William R
WR
Burket
Mark W
MW
Thomas
William J
WJ
Khuder
Sadik A
SA
Shapiro
Joseph I
JI
Topp
Robert V
RV
Cooper
Christopher J
CJ
D000368:Aged; D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000523:psychology*; D011184:Postoperative Period; D011788:Quality of Life; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents