title: Perception of uncontrolled blood pressure and non-adherence to anti-hypertensive agents in diabetic hypertensive patients.
abstract: We assessed the association between adherence to antihypertensive drug treatment and patient's perception of uncontrolled blood pressure (BP) in diabetic hypertensive subjects. This was a cross-sectional study that evaluated adherence to antihypertensives (Morisky questionnaire), patients' perception of abnormal BP, office BP, and ambulatory BP monitoring in diabetic hypertensive subjects. We evaluated 323 patients, 65.2% women, aged 56.5 ± 7 years, glycosylated hemoglobin (HbA1c) 8.0% (range, 6.9%-9.6%), diabetes duration of 10 years (range, 5-17 years). Adherence to drug treatment was 51.4%. Patients who reported hypertension-related symptoms (60.4%) had a lower level of adherence (P < .001). Non-adherence occurred four times more frequently in patients who reported hypertension-related symptoms (P < .001, adjusted for use of three or more anti-hypertensives, age, and duration of diabetes). Non-adherents had higher office diastolic BP (83.6 ± 11.9 vs. 79.8 ± 9.9; P = .003), but no difference between groups was observed considering systolic, diastolic, and mean BP evaluated by ambulatory BP monitoring. Low rates of adherence to antihypertensive drug treatment were observed in outpatient hypertensive diabetic subjects. Perception of uncontrolled BP levels was strongly and independently associated with non-adherence. Non-adherence determined repercussion on office BP that may have clinical implications in cardiovascular risk.
authors: Endocrine Division, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors: P S
authors: PS
authors: Ledur
authors: Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors: L F
authors: LF
authors: Leiria
authors: Endocrine Division, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors: M D
authors: MD
authors: Severo
authors: Department of Medical Surgical, School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors: D T
authors: DT
authors: Silveira
authors: Endocrine Division, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors: D
authors: D
authors: Massierer
authors: Endocrine Division, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors: A D
authors: AD
authors: Becker
authors: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
authors: F M
authors: FM
authors: Aguiar
authors: Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors: M
authors: M
authors: Gus
authors: Endocrine Division, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: beatrizschaan@gmail.com.
authors: B D
authors: BD
authors: Schaan
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Diabetes mellitus; hypertension; medication adherence