• 作者：Emilio Má ; rquez-Contreras^a ; ^b ; ^{emarquezc@papps.org} ; Mariano de la Figuera-Von Wichmann^a ; ^c ; Josep Franch-Nadal^a ; ^d ; Jose Luis Llisterri-Caro^a ; ^e ; Vicente Gil-Guillé ; n^a ; ^f ; José ; Luis Martí ; n-de Pablos^a ; ^b ; José ; Joaquin Casado-Martí ; nez^a ; ^b ; Nieves Martell-Claros^a ; ^g
• 关键词：ARA-II ; antagonistas de los receptores de la angiotensina II ; HTA ; hipertensi&oacute ; n arterial ; IECA ; inhibidores de la enzima de conversi&oacute ; n de la angiotensina ; MEMS ; monitores electr&oacute ; nicos de control de la medicaci&oacute ; n (medication eve
• 刊名：Revista Espa?ola de Cardiolog篓陋a
• 出版年：2012
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：June, 2012
• 卷：65
• 期：6
• 页码：544-550
• 文件大小：291 K

lass="h4">Introduction and objectives

To assess compliance with treatment inhibit the renin-angiotensin system (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) in uncontrolled hypertension in patients at high cardiovascular risk.

lass="h4">Methods

Prospective, longitudinal, multicenter study, carried out in 102 Spanish primary care centers. We included 808 uncontrolled hypertensive patients treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers who were at high vascular risk; 4 visits were conducted: baseline and 1, 3, and 6 months later. Compliance was measured by electronic monitors. We calculated the mean percentage compliance, the overall percentage of compliers, once-daily compliers, compliers with the prescribed time frame, and antihypertensive coverage. We considered a patient to be a complier when the percentage compliance was 80%-100%.

lass="h4">Results

In all, 701 patients completed the study (mean age, 63.7 [11.1] years). The systolic and diastolic blood pressures decreased significantly (P<.0001) to 18.8 mmHg and 9.8聽mmHg, respectively. The control rate was 70%(95%confidence interval, 65.6%-74.4%) (P=.0001). The rate of control was significantly higher among compliers than noncompliers (P<.05). The mean percentage of doses taken was 87.9%(95%confidence interval, 84.8%-91%) and the mean therapeutic coverage was 82.4%(95%confidence interval, 78.7%-86.1%). Overall, 73.3%of the patients were compliers (95%confidence interval, 69%-77.6%), 52.8%(95%confidence interval, 48%-57.6%) were once-daily compliers, and 46.5%(95%confidence interval, 41.9%-51.1%) complied with the prescribed time frame. Noncompliance was associated with a higher number of drugs prescribed (P<.001).

lass="h4">Conclusions

In hypertensive patients at high vascular risk, the rate of therapeutic noncompliance was very high, mainly when they took 5 or more pills daily.

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