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Review
. 2021 Nov-Dec;73(6):667-673.
doi: 10.1016/j.ihj.2021.09.003. Epub 2021 Sep 15.

Therapeutic adherence in hypertension: Current evidence and expert opinion from India

Jamshed J Dalal  1 , Prafulla Kerkar  2 , Santanu Guha  3 , Arup Dasbiswas  4 , J P S Sawhney  5 , Sivakadaksham Natarajan  6 , Srinivasa Rao Maddury  7 , A Sreenivas Kumar  8 , Nishith Chandra  9 , Gulla Suryaprakash  10 , Joy M Thomas  11 , N I Juvale  12 , Sunil Sathe  13 , Aziz Khan  14 , Sandeep Bansal  15 , Viveka Kumar  16 , Rajshekhar Reddi  17
Affiliations
Review

Therapeutic adherence in hypertension: Current evidence and expert opinion from India

Jamshed J Dalal et al. Indian Heart J. 2021 Nov-Dec.

Abstract

Hypertension (HTN) is a globally prevalent non-communicable disease contributing significantly to cardiovascular (CV) morbidity and mortality. In achieving control of HTN, therapeutic adherence plays a crucial role. Studies from India identify varying rates of adherence to antihypertensive medications. Multiple factors determine treatment adherence in HTN. In India, factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness, cost of medications, and duration of HTN determine the adherence. An excellent physician-patient relationship incorporating adequate counseling along with the use of other methods can identify poor adherence. Improving adherence necessitates incorporating a multipronged approach with strategies directed at physicians, patients, and health systems. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Furthermore, increasing adherence to lifestyle interventions can help achieve better HTN control and improve CV outcomes. In the Indian context, more emphasis is necessary on patient education, enhanced physician-patient relationship and communication, increased access to health care, and affordability in improving therapeutic adherence in HTN.

Keywords: Adherence; Antihypertensives medications; Blood pressure; Cardiovascular disease; Hypertension.

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Figures

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Fig. 1
Factors affecting adherence to medication.
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Fig. 2
Adherence rates to different cardiovascular medications.
Fig. 3
Fig. 3
Methods for the detection of poor adherence.
See this image and copyright information in PMC

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