BMJ 2001;323:1129 ( 10 November )

Letters

Antihypertensive treatment and compliance

    Non-adherence should be addressed first
    Study was too short and lacked active intervention
    Pharmacological properties of antihypertensive drugs research need to be acknowledged
    Author's reply

Non-adherence should be addressed first

The first 150 words of the full text of this article appear below.

EDITOR---Nuesch et al showed in their study that electronic monitoring of patient's adherence had no significant effect on ambulatory blood pressure.1 Because non-adherence was not more prevalent among patients with resistance to antihypertensive treatment, they concluded that other factors independent of a patient's willingness to adhere are more relevant in explaining failure of treatment in most patients. These results should, however, be interpreted with caution because of possible selection and differential measurement bias that may have occurred in the study.

Patients who accepted inclusion in the study and were therefore monitored for blood pressure and adherence may adhere more to antihypertensive treatments than the general population. We have no information about how many eligible patients refused to participate. Furthermore, after 28 days of study and on the basis of the results of ambulatory blood pressure, more patients became responsive to treatment than became non-responsive (chi 2=2.9, P<0.09)---14/49 (28.6%) . . . [Full text of this article]
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Relevant Article

Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study
Reto Nuesch, Kerstin Schroeder, Thomas Dieterle, Benedict Martina, and Edouard Battegay
BMJ 2001 323: 142-146. [Abstract] [Full Text] [PDF]

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