Adverse Symptoms and Effectiveness of Treatment of Essential Arterial Hypertension

Abstract

Background There is evidence from studies in Poland and in other countries on poor effectiveness of hypertension control. One of the causes could be poor adhesion to the medical advising due to adverse symptoms in the course ofblood pressure lowering treatment. The goals of the present study were: 1) to assess the frequency ofadverse symptoms in the course of blood pressure lowering treatment, 2) to assess the patient's adherence to the medical advising, 3) to assess the relation between adverse symptoms and patient's adherence to medical advising, effectiveness of treatment of hypertension and patient's satisfaction with treatment.
Methods Studied group consisted of283 subjects: 146 men and 137 women (mean age: 54 years, SD = 12,1 and 55 years, SD = 11,8 respectively) with essential hypertension. In treatment of hypertension, monotherapy was used in 15% patients, and in the 85% two or more drugs were used. The most common blood pressure lowering agents were ACE-inhibitors (74%), diuretics (48%), ß-blockers (47%), calcium antagonists (39%) and vasodilatators (16%). Other drugs were used in less than 10% patients.
Results Blood pressure below 140/90 mm Hg was found in 24% patients. Adverse symptoms were reported spontaneously by 24% patients (in 3,4% of patients adverse symptoms were the cause ofthe visit), additional 10% confirmed the presence of adverse symptoms after being asked by the doctors for symptoms related to the use of antihypertensive drugs. However, 71% patients confirmed the presence ofsymptoms, which could be related to the treatment of hypertension in the detailed interview. In 34% of patients, physician confirmed association of symptoms with the drugs used. In the latter group of patients the most common symptoms were: dryness in the mouth, polyuria and cough (about 10% patients).
Conclusion Presence of adverse symptoms was related to more frequent visits. Presence of adverse symptoms was not related to poorer adherence to medical advice, to worse satisfaction with treatment and to poorer effectiveness of treatment.