title: Blood pressure treatment adherence and control through 24-hour ambulatory monitoring.
abstract: BACKGROUND
  Although systemic arterial hypertension (SAH) is an important cardiovascular risk factor, blood pressure level control often remains inadequate. Assessment of adherence to antihypertensive treatment through 24-hour ambulatory blood pressure monitoring (ABPM) may represent an important aid in the search for BP control targets.
  
  
  OBJECTIVE
  To assess adherence to antihypertensive treatment and its association with BP values at 24-hour ABPM in hypertensive patients treated in primary health care (PHC) centers.
  
  
  METHODS
  We carried out a cross-sectional study of 143 hypertensive patients, who constituted a representative sample of patients from PHC centers in the town of Antonio Prado, RS. The Morisky-Green test was used to evaluate adherence and verify the number of medications used by patients, followed by 24-hour ABPM.
  
  
  RESULTS
  We observed that 65.7% of the sample was considered adherent to the proposed treatment, 20.3% were moderately adherent and only 14% were classified as non-adherent. Considering all the 143 patients evaluated, 79 (55.2%) were identified as having controlled hypertension (<130/80 mmHg) according to the 24-hour ABPM measurements, 64 (44.8%) were considered uncontrolled (>130/80 mmHg), 103 (72%) had absence of nocturnal BP dip and 60 (41.9%) were uncontrolled while awake.
  
  
  CONCLUSIONS
  In this study, we observed a lack of adequate hypertension control with a consequent loss of opportunity for PHC professionals to adequately adjust the recommended BP control targets. This fact occurs in spite of proper adherence to antihypertensive treatment by patients in PHC centers.
authors.affiliation: Fundação Universitária de Cardiologia do Rio Grande do Sul, IC, Porto Alegre, RS, Brasil. gbgrezzana@cardiol.br
authors.forename: Guilherme Brasil
authors.initials: GB
authors.lastname: Grezzana
authors.forename: Airton Tetelbon
authors.initials: AT
authors.lastname: Stein
authors.forename: Lúcia Campos
authors.initials: LC
authors.lastname: Pellanda
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents