Understanding Uncontrolled Hypertension: Is It the Patient or the Provider?
Article first published online: 19 DEC 2007
The Journal of Clinical Hypertension
Volume 9, Issue 12, pages 937–943, December 2007
How to Cite
Rose, A. J., Berlowitz, D. R., Orner, M. B. and Kressin, N. R. (2007), Understanding Uncontrolled Hypertension: Is It the Patient or the Provider?. The Journal of Clinical Hypertension, 9: 937–943. doi: 10.1111/j.1524-6175.2007.07332.x
- Issue published online: 19 DEC 2007
- Article first published online: 19 DEC 2007
- Manuscript received July 30, 2007; accepted August 16, 2007
The relative contributions of adherence and treatment intensity to blood pressure (BP) control are not well understood. The authors studied patients with uncontrolled hypertension (N=410) from 3 primary care clinics in the Veterans Affairs (VA) medical system. A questionnaire was used to assess patient adherence to therapy, and VA system pharmacy fills were used to assess the intensity of the antihypertensive regimen. At baseline, an inadequate antihypertensive regimen was implicated as the most probable reason for uncontrolled BP in a majority of patients (72%), while nonadherence could only be implicated in 13%. In multivariate longitudinal analyses, patients who had an increase in their medical treatment during the study had lower final diastolic BP levels compared with the patients who did not (−3.70 mm Hg; P<.05). While patient adherence to therapy plays a role, vigorous clinical management by the clinician is a more important contributor to BP control.