Study on compliance of anti-hypertensive drugs among hypertensive patients in urban health centre of a tertiary care hospital

Dhanasekar Gurupatham, Jeevithan Shanmugam, John William Felix, Sandhya L. M.


Background: Hypertension is a chronic condition of concern due to its role in the cardiovascular complications. Poor compliance is assumed to be an important explanation for inadequate blood pressure control, convincing evidence for the same is lacking. This study was undertaken to provide such evidence, so that corrective measures can be recommended to attain better BP control. The aims and objectives of the study were to study compliance pattern and side effects of anti-hypertensive drugs among the known hypertensive patients; to study role of different factors that influence the compliance rate such as age, number of medications, frequency and follow-up visits of antihypertensive medication.

Methods: A total of 207 hypertensive patients were identified from the family folders maintained in the Urban Health Centre, RMMCH and included in the investigation. During first visits, socio-demographic, drug intake history was taken. Follow up was done every two months and thus totally six visits were completed.

Results: Socio demographic factors like age, marital status, literacy, occupation and income have no role on the compliance status. Sex has significant association with the compliance level (86.1%), where males have 93.4% and females 82.7% compliance (p<0.05). BMI, exercise, smoking and alcohol, Type of the drug, doses frequency, combination therapy and regularity in refilling the prescription, have no association with compliance status. Frequency of clinical visits has significant association with compliance (visit fortnightly, monthly and occasionally is 94.1%, 85.1% and 75% respectively) p<0.05. Significant improvement (73.1%) improvement in compliance in the VI visit is seen among non-compliers from I visit (p<0.001).

Conclusions: Simple once a day regimen and visits of the health provider improves the compliance and good blood pressure control.


Hypertension, Compliance, Anti-hypertensive drugs, BP control

Full Text:



WHO (2011). Global status report on non-communicable diseases 2010.

Govt. of India. National health report 2011, Ministry of Health and Family Welfare, New Delhi, 2011.

Seventh report of the JNC on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7), December 2003 in Hypertension, 2003;42:1206.

Monane M, Bohn RL, Gunvitz JH, Glynn RJ, Levin R, Avom J. Compliance with Antihypertensive Therapy among Elderly Medicaid Enrollees: The Roles of Age, Gender, and Race. Am J Public Health. 1996;86(12):1805–8.

Akpa MR, Agomuoh DI, Odia OJ. Drug compliance among hypertensive patients in Port Harcourt, Nigeria. Nigerian J Med: journal of the National Association of Resident Doctors of Nigeria 2005;14(1):55-7.

Kabir M, Iliyasu Z, Abubakar IS, Jibril M. Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria. J Community Med Primary Health Care. 2004;16(1):16-20.

Al-Homrany MA, Khan MY, Al-Khaldi YM, Al-Gelban KS, Al-Amri HS. Hypertension care at primary health care centres: A report from Abha, Saudi Arabia. Saudi Med J. 2008;19(6):990-6.

Hershe JC, Gorton BG, Davis JB, Reichgott MJ. Patient Compliance with Antihypertensive Medication. Am J Public Health. 1980;70(10):1081-9.

Shankar L, Lavanya K, Thampi RR, Jose J. Prevalence and Determinants of Drug Compliance among Hypertensive Patients Paper Presented - 2nd National Conferences on Students Medical Research, Trivandrum, 2009.

Lagi A, Rossi A, Passaleva MT, Cartei A, Cencetti S. Compliance with therapy in hypertensive patients. J Internal Emergency Med. 2006;1(3):204-8.

Jesus ES, Aparecida M, Gusmao J. Profile of hypertensive patients: Biosocial characters, Knowledge, and Treatment compliance. Acta Paul Enferm. Sau Paulo. 2008;21(1):59-65.

Hadi N, Rostami-Gooran N. Determinant factors of medication compliance in hypertensive patients of Shiraz, Iran. Arch Iranian Med. 2004;7(4):292-6.

Palanisamy S, Sumathy A. Intervention to improve patient adherence with Antihypertensive Medications at a tertiary care teaching hospital. Sumathy. Int J PharmTech Res. 2009;1(2):369-74.

Ahmed N, Abdul Khaliq M, Shah SH, Anwar W. Compliance to Antihypertensive drugs, Salt restriction, Exercise and control of Systemic hypertension in Hypertensive patients at Abbotabad. J Ayub Med Coll Abbottabad. 2008;20(2):66-9.

Perreault S, Lamarre D, Blais L, Dragomir A, Berbiche D, Lalonde L, et al. Persistence with Treatment in Newly Treated Middle-Aged Patients with Essential Hypertension. Ann Pharmacother. 2005;39(9):1401-8.