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. 2024 May;31(3):309-320.
doi: 10.1007/s40292-024-00642-4. Epub 2024 Jun 3.

May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey

Rita Del Pinto #  1 , Claudia Agabiti Rosei #  2 , Claudio Borghi  3 , Franco Cipollini  4 , Santina Cottone  5 , Giuseppe Antonio De Giorgi  6 , Antonino Di Guardo  7 , Maurizio Dugnani  8 , Bruno Fabris  9 , Cristina Giannattasio  10 , Gilberta Giacchetti  11 , Pietro Minuz  12 , Giuseppe Mulè  5 , Pietro Nazzaro  13 , Gianfranco Parati  14   15 , Marcello Rattazzi  16 , Francesca Saladini  17 , Massimo Salvetti  18 , Riccardo Sarzani  19 , Carmine Savoia  20 , Giuliano Tocci  20 , Franco Veglio  21 , Massimo Volpe  22 , Vito Vulpis  23 , Gianluca Baldini  1 , Claudio Ferri  24 , Maria Lorenza Muiesan  2
Affiliations

May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey

Rita Del Pinto et al. High Blood Press Cardiovasc Prev. 2024 May.

Abstract

Introduction: Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side.

Methods: During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures.

Results: A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%).

Conclusions: This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.

Keywords: Blood pressure; Hypertension; Prevention campaigns; Therapeutic inertia.

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Conflict of interest statement

The authors declare no conflicts of interests. MLM declares travel support from Servier®.

Figures

Fig. 1
Fig. 1
Upset plot showing intersections of factors (overweight-obesity, male sex, sedentary lifestyle, older age, self-reported diagnosis of periodontitis and its signs, tobacco smoking, daily alcohol use, and diabetes) in individuals with BP ≥ 140 and/or 90 mmHg on their first BP assessment (panel a) and in the subset of individuals with uncontrolled hypertension (panel b). The rows of the matrix correspond to the factors, and the columns to the intersections between these factors
Fig. 2
Fig. 2
Attitude towards use of antihypertensive drugs (regular use, forgetfulness, unavailability, and as needed use) among participants with controlled (left) and uncontrolled (right) hypertension. Percentages of individuals for each category are reported
Fig. 3
Fig. 3
Individuals (%) on a fixed-dose combination of antihypertensive drugs among participants with controlled (left) and uncontrolled (right) hypertension. Percentages of individuals for each category are reported
See this image and copyright information in PMC

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