Relationship between blood pressure levels and adherence to medication in patients with chronic heart failure: how come?
OBJECTIVE
To investigate whether change in objective signs during up-titration of angiotensin-converting enzyme (ACE)-inhibitors in patients with chronic heart failure affect perception of information about medicines and subjective activities such as self-care.


METHODS
Consecutive patients referred for up-titration of ACE-inhibitors were included. Patients were given the Satisfaction with Information about Medicines Scale and the European Heart Failure Self-Care Behaviour Scale at their first visit and when the target dose was reached. Blood pressure, pulse and s-creatinine were measured at each visit.


RESULTS
Relationships were found between change in systolic (r = 0.224, p = 0.044) and diastolic (r = 0.361, p = 0.001) blood pressure and change in self-care scores and were also observed at baseline (r = 0.324, 0.398, p = 0.001, 0.000) and follow-up (r = 0.317, 0.253, p = 0.004, 0.022). Diastolic blood pressure correlated with the "potential problem of medication" score (r= -0.263, p = 0.007).


CONCLUSIONS
Patients with a more advanced disease usually have a lower blood pressure. Hence, the relationship between blood pressure and self-care scores might indicate that patients are more motivated to adhere to prescriptions the more advanced the stage of their disease.
Mohammadi
Mahsa
M
Department of Medicine, The Sahlgrenska Academy at Goteborg University, Goteborg, Sweden. mahsa@student.gu.se
Ekman
Inger
I
Schaufelberger
Maria
M
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D012648:Self Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents