Abstract 19760: Factors Influencing Blood Pressure Control and Therapeutic Adherence in a Comprehensive Hypertension Management Program

Abstract

Background: Lack of life style modification counseling, poor antihypertensive drug therapy (Rx) adherence, low education, poor patient-physician relation have been described among other social determinants as hurdles in achieving blood pressure (BP) control in hypertensive patients. Objectives: This study assesses these factors in a government sponsored Cardiovascular Health Program (CHP) that provides free access to antihypertensive treatment and life style modification counseling to Chilean hypertensive population.

Methods: From a universe of 1,512 hypertensive patients (1,069 women) between 30 y 68 years followed throughout the CHP, a sample of 349 patients was analyzed. All patients received free Rx and life style modifying counseling. Surveys of physician-patient relationship, weekly physical activity (leisure physical activity) family income and education level were carried out. Rx adherence was determined using the Morisky-Green-Levine test. Odds ratio (OR) analysis adjusted for age and sex was performed to assess the influence of these factors in BP control (<140/90 mmHg) and Rx adherence.

Results: The mean age of the sample was 55.0 ± 8.2 years. BP control was achieved in 49.0% (741 of 1,512) of patients. 94,5% (1,429 of 1,512) received pharmacological treatment. Adherence to antihypertensive Rx was 34.9% (499 of 1,429). Factors related to BP control and influencing Rx adherence with their OR are shown in Table 1.

Conclusions: Education, patient-physician relation, low social support and physical activity level influenced BP control. The same factors with the exception of physical activity level influenced Rx adherence that did not appear to affect decisively BP control. These results underscore the importance of social determinants and life style modification counseling implemented throughout this comprehensive hypertension management in the Chilean CHP.