title: [Influence of psychosocial factors on adherence to antihypertensive drug therapy: results from a Cardiovascular Health Program cohort followed in the Metropolitan Region of Santiago, Chile].
abstract: BACKGROUND
  Inadequate blood pressure control in hypertensive patients remains a persistent health problem in Chile and worldwide. Poor adherence to antihypertensive drug therapy is one of the frequently cited factors.
  
  
  OBJECTIVE
  To determine the influence of psychosocial factors in the adherence to drug therapy in hypertensive patients followed through a Cardiovascular Health Program (CHP) that provides free access to primary care centers located in the Metropolitan Region of Santiago, Chile.
  
  
  METHODS
  Cross sectional study. A randomized sample of 513 hypertensive patients (30 to 68 years) was obtained from a universe of 1.484 patients. Adherence to treatment was determined by the Morisky-Green-Levine test. Demographic, socioeconomic and average values of blood pressure were recorded. Validated questionnaires were utilized to assess the patient-physician relationship, awareness of being hypertensive, patient perception of social support, family cohesion, patient self-health assessment and symptoms of emotional stress and depression.
  
  
  RESULTS
  The drug therapy adherence was 36.6%, higher in women (38.4% vs 28.9%; p < 0.001). After multivariate analysis, absence of adherence was associated with male gender (OR: 1.76 [95% CI 1.21-2.56]), low education (OR: 1.72 [95% CI 1.18 to 2.53]), inadequate patient-physician relationship (OR: 1.56 [95% CI 1.13 to 2.27]), and high level of emotional stress and depression (OR: 1.93 [95% CI 1.27 to 2.94]).
  
  
  CONCLUSIONS
  Our study highlights the influence of inadequate patient-physician relation, high level of emotional stress and depression, low education level and income and male gender in the lack of adherence to antihypertensive drug therapy in hypertensive patients followed throughout the CHP.
authors.forename: Daniela
authors.initials: D
authors.lastname: Sandoval
authors.forename: Javier
authors.initials: J
authors.lastname: Chacón
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Muñoz
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Henríquez
authors.forename: Elard
authors.initials: E
authors.lastname: Koch
authors.forename: Tomás
authors.initials: T
authors.lastname: Romero
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002677:Chile; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents