Adverse effects and non-adherence to antihypertensive medications in University of Gondar Comprehensive Specialized Hospital

Abstract

BackgroundA considerable proportion of cardiovascular events could be attributed to poor adherence to antihypertensive medications. Adverse effects can be severe enough to affect adherence to antihypertensive medications. This study aimed to measure the contribution of adverse effects on antihypertensive medications adherence.MethodsThe study was conducted from May 1 to June 30, 2017, at the ambulatory clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH) in Gondar town. A binary logistic regression was performed to determine the significance of the association between adverse effects and adherence to antihypertensive medications. An institution-based cross-sectional study was conducted by administering a questionnaire to hypertensive patients who came for follow-up at the ambulatory clinic of UOGCSH. Level of adherence to antihypertensive medications was used as outcome measure.ResultsA total of 249 patients were included in the final analysis with a mean age of 56.51 years and a female majority (53%). The following variables were identified as predictors of poor adherence: tiredness [AOR (95% CI): 3.802 (1.723–8.391), p = 0.001], muscle pain [AOR (95% CI): 5.199 (1.407–19.214), p = 0.013], poor sleep [AOR (95% CI): 4.891 (1.578–15.160), p = 0.006] and, believing that the symptoms were caused by antihypertensive medications [AOR (95% CI): 3.249 (1.248–8.456), p = 0.016].ConclusionAdverse effect significantly contributes to antihypertensive medication non-adherence among hypertensive patients.

Evaluation of blood pressure control and associated factors among patients with hypertension in Iraq: a prospective cross-sectional study

“…[29] Alternatively, patients may opt to stop their medication on experiencing initial side effects such as increased urination with diuretics. [30] The asymptomatic nature of the illness, which is often called a silent killer, requires additional efforts to increase medication adherence and decrease the proportion of patients with uncontrolled hypertension. Further work is needed to characterize medication adherence in Iraqi patients with hypertension.…”

Counter-regulatory renin–angiotensin system in cardiovascular disease

“…Furthermore, many of these patients require two or more doses each day 140 , suggesting that the separate use of ACE inhibitors or angiotensin II receptor antagonists is not always effective. The use of more than one drug and the need for multiple doses per day can increase the incidence of adverse events, which can result in loss of adherence 140,141 . In addition, a longitudinal study that evaluated the dosing histories of 4,783 patients taking antihypertensive drugs found that nearly half of the patient cohort discontinued the treatment 142 , which results in poorly controlled hypertension 143 .…”

Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

“…The full-text papers of 31 articles were retrieved and reviewed for inclusion which resulted in a total of 18 studies eligible for the methodological quality assessment. After excluding four studies with reasons mainly a weak quality score, 14 studies were included in the final SR (qualitative synthesis) [19][20][21][22][23][24][25][26][27][28][29][30][31][32] and 12 of them were also included in MA ( Figure 1).…”