title: Adherence to Antihypertensives in Patients With Comorbid Condition.
abstract: BACKGROUND
  Comorbidity has been noted as a potential barrier to proper adherence to antihypertensive medications.
  
  
  OBJECTIVE
  We decided to investigate whether comorbidity could significantly affect adherence of Iranian patients with hypertension to their medication regimen.
  
  
  METHODS
  Two hundred and eighty consecutive hypertensive patients were interviewed in 4 cities of Iran. The 8-item Morisky medication adherence scale (MMAS-8) (validated in Persian) was used to assess medication adherence. This scale determines adherence by scores as lower than 6 (low adherence), 6 or 7 (moderate adherence), and 8 (high adherence). Comorbidity was considered as any concomitant medical condition, which necessitates the patient to take medicine for a minimum of 6 months prior to the interviews.
  
  
  RESULTS
  The most common comorbid conditions were ischemic heart disease (65 patients, 23.2%), diabetes mellitus (55 patients, 19.6%), and dyslipidemia (51 patients, 18.2%). Mean (± SD) MMAS-8 score in comorbid group was 5.68 (± 1.85) and in non-comorbid hypertensive patients, it was 5.83 (± 1.91) (P = 0.631). Mean (± SD) number of comorbidities was 1.53 (± 0.75) in low adherence group compared to 1.54 (± 0.77) in moderate/high adherers (P = 0.98). With increasing the number of comorbid diseases, the proportion of patients with high adherence decreased successively from 20% in those with no comorbid disease to 14.1% in those with one or two comorbid conditions, and finally 11.1% in those with 3 to 5 comorbid conditions.
  
  
  CONCLUSIONS
  With increasing the number of comorbid conditions, the proportion of patients with high adherence decreases. In our opinion, this finding is a useful clinical note for healthcare providers when managing patients with hypertension who have other medical problems at the same time.
authors.affiliation: Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Saadat
authors.affiliation: Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farahnaz
authors.initials: F
authors.lastname: Nikdoust
authors.affiliation: Department of Cardiology, Shahid Sadoughi University of Medical Sciences, Bafgh,Kermanshah, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Aerab-Sheibani
authors.affiliation: Department of Cardiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Bahremand
authors.affiliation: Department of Radiology, Kermanshah University of Medical Sciences,Kermanshah, IR Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Shobeiri
authors.affiliation: Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Saadat
authors.affiliation: Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Yashar
authors.initials: Y
authors.lastname: Moharramzad
authors.affiliation: Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Morisky
keywords: Antihypertensive agents; Comorbidity; Hypertension; Iran; Medication adherence