Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study

Objectives To prospectively compare compliance with treatment in patients with hypertension responsive to treatment versus patients with treatment resistant hypertension. Design Prospective case control study. Setting Outpatient department in large city hospital in Switzerland, providing primary, secondary, and tertiary care. Participants 110 consecutive medial outpatients with hypertension and taking stable treatment with at least two antihypertensive drugs for at least four weeks. Main outcome measures Treatment compliance assess with MEM devices; blood pressure determined by 12 hour daytime ambulatory monitoring (pressure <135/85 mm Hg in patients age <less than or equal to>60 years and <155/90 mm Hg in patients aged >60 indicated hypertension responsive to treatment). Results Complete data were available for 103 patients, of whom 86 took greater than or equal to 80% of their prescribed doses ("compliant") and 17 took <80% ("non-compliant"). Of the 49 patients with treatment resistant hypertension, 40 (82%) were compliant, while 46 (85%) of the patients responsive to treatment were compliant. Conclusion Non-compliance with treatment was not more prevalent in patients with treatment resistant hypertension than in treatment responsive patients.