The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (χ 2 =21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (χ 2 =19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%).The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.
Alteplase with modern adjuvant therapy of ST segment elevation acute myocardial infarction shows the earlier achievement of coronary perfusion as well as better coronary flow compared to streptokinase. There is no statistically significant difference in the frequency of reperfusion arrhythmias, degree of residual stenosis at the"culprit"artery and the frequency of new coronary events in the 6-month-follow-up period after acute myocardial infarction.
The cause of pericarditis should always be searched for. On the other hand, during monitoring or treatment of numerous conditions which could be a frequent cause of pericarditis, the presence of pericardial effusion or cardiac tamponade should be suspected and detected in due time. A timely intervention--pericardiocentesis, can prevent the fatal outcome. Besides non-steroid anti-inflammatory medication, many prospective randomised studies propose colchicine as addition to the standard therapy. When opting for the proper treatment for pericarditis always keep in mind the current diagnosis and cause of this condition.
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