Antihypertension medication adherence and associated factors at tertiary care hospital, Gujarat, India


  • Dinkar Goswami Department of Medicine, GMERS Medical College, Gandhinagar, Gujarat, India



Hypertension, Medical compliance, Patient-physician interaction, Treatment adherence


Background: According to world health organization (WHO) describes poor adherence as the identical cause of uncontrolled blood pressure and estimates that 50-70% of people do not take their antihypertensive medication as prescribed. The objectives of this study were to investigate the adherence and persistence of antihypertensive drugs in Indian rural population as well as monitoring adverse drug reactions and its relation to compliance.

Methods: This cross-sectional study conducted among 300 hypertensive patients taking treatment at tertiary care hospital in Gujarat, India. Structured questionnaires consisting of open and closed ended questions on the antihypertensive drug adherence were distributed to patients for those found on the study area at time of data collection and the left-over pills of individual patient were counted to strengthen the consistency of the research.

Results: Prevalence of non-adherence found in 24.3% participants. Present study found statistically significant association between socio-demographic factors (age, religion, marital status, occupation, substance abuse, education and family history of HT) with treatment adherence of hypertension among study participants. The other factor associated to non-adherence was therapy factor 32.9% (P=0.001) from the total non-adherence, in this case patients were supposed to unwanted effect of the drug and they were not able to take the medication.

Conclusions: The main possible reasons for non-adherence were ‘refuse to take regular treatment’,‘cost of treatment’, ‘poor patient-doctor relation’, ‘unwanted side effect of drugs’ and other factors like age, marital status, occupation, education level, family H/O, substance abuse and religion are also playing supporting role to develop non-adherence to treatment.


Pardeshi M, Dange SV. Comparison of Efficacy and Safety of Amlodipine and Felodipine-ER in Patients of Essential Hypertension. Bomb Hosp J. 2004;46(2).

Nissinen A. Hypertension in developing countries, World Health Statis Quart. 1998;41:141-54.

Chelkeba L, Dessie S. Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia. Int J Res Med Sci. 2013;1(3):101-7.

Tal H. Assessment to antihypertensive medication association with patient and practice factors. J Human Hypertens. 2006(20):295-7.

Praveen K, eds. Cardiovascular disease, Kumar and Clarke’s clinical medicine. 5th Ed. 2002:818.

Boon NA, eds. Cardiovascular disease. Davidson’s principals and practice of medicine. 19th Ed. 2002:392.

Kale S, Patil A, Mandlecha RH. Compliance and adverse drug effects of antihypertensives in rural India. J Clinic Diag Res. 2011;5(4):775-9.

Verma A, Patel P, Patel JR, Chaudhary H. Relation of BMI and hypertension in natives of Gujarat. GCSMC J Med Sci. 2013;2(1):17-20.

Ho PM, Spertus JA, Masoudi FA, Reid KJ, Peterson ED, Magid DJ, et al. Impact of medication therapy discontinuation on mortality after myocardial infarction. Arch Inter Med. 2006;166(17):1842-7.

Newby LK, LaPointe NMA, Chen AY, Kramer JM, Hammill BG, DeLong ER, et al. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circ. 2006;113:203-12.

Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002;288:462-7.

Venkatachalam J, Abrahm SB, Singh Z, Stalin P, Sathya GR. Determinants of patient's adherence to hypertension medications in a rural population of Kancheepuram District in Tamil Nadu, South India. Indian J Community Med. 2015;40:33-7.

Santra G. Assessment of adherence to cardiovascular medicines in rural population: An observational study in patients attending a tertiary care hospital. Ind J Pharm. 2015;47(6):603-4.

Thakur JS, Vijayvergiya R, Jaswal N, Ginsburg A. Assessment and barriers to medication adherence for secondary prevention of cardiovascular disease among patients with coronary artery disease in Chandigarh, India. Int J Noncommunicab Dis. 2016;1(1):37.

Ramli A, Ahmad NS, Paraidathathu T. Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patient Prefer Adher. 2012;6:613.

Bhusal A, Jadhav PR, Deshmukh YA. Assessment of medication adherence among hypertensive patients: a cross-sectional study. Int J Basic Clin Pharmacol. 2016;5:1606-12.

Todd M. Medication adherence in hypertension study. J Human Hypertens. 2009;3:840.

Premier collaborative research group, effects of comprehensive lifestyle modifiation on blood pressure control: main results of the premier clinical trial. J Am Med Assoc. 2003;289:2083-93.

The colombo plan for cooperative economic development in south and southeast Asia. Annual report of the consultative committee. 22nd consultative committee. Sri Lanka, Colombo Plan Bureau. 1972; 990-998. Available at:

Lesaffre E. A retrospective analysis of the effect of noncompliance on time to first major adverse cardiac event in LIPS. Clin Ther. 2003;25:2431-47.

Guidelines committee. 2003. European society of hypertension European society of cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003;21:1011-53.

Lewis LM, Askie P, Randleman S, Shelton-Dunston B. Medication adherence beliefs of Comm Dwellling Hyper African Am. J Cardiovasc Nurs. 2010;25:199-206.

Harmon G, Lefante J, Krousel-Wood M. Overcoming barriers: the role of providers in improving patient adherence to antihypertensive medications. Curr Opin Cardiol. 2006;21:310-5.






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