Forgetting to take blood pressure medication increases risk of stroke for hypertension patients

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A Finnish study may have important implications for patients with hypertension. The study found that patients who do not adhere to guidelines in taking medication to lower blood pressure are at an increased risk for both fatal and nonfatal strokes.

Kimmo Herttua, PhD, of the University of Helsinki, and colleagues examined data from Finnish national registries from 1995 through 2007. The analysis included 73,527 individuals 30 years of age and older. These individuals required antihypertensive therapy and were initially free from stroke and cardiovascular disease. The study, published online in the European Heart Journal, analyzed prescriptions, hospitalizations and deaths.

Adherence to the medication guidelines was determined by the number of days covered by a filled prescription. Analyses were adjusted for age, sex, length of antihypertensive therapy, education, household income, diabetes, and history of cancer. The results showed that 2,144 patients died and another 24,560 were hospitalized for stroke. Patients who did not adhere to treatment had increased odds of both fatal and non-fatal stroke.

The researchers acknowledged that there were shortcomings of this type of measurement, as prescription refills do not guarantee that the patient was actually taking the pills, but suggest that this information should urge doctors to discuss the importance of medication adherence with their patients.

"It tells you that if you are prescribing medicine for high blood pressure you need to make every effort to make sure that your patient is adherent to the treatment, said Suzanne Oparil, MD, of the University of Alabama at Birmingham

ACSH S Dr. Gilbert Ross echoed Dr. Oparil s advisory, adding this: Hypertension is an insidious and pervasive silent killer. Although almost entirely without symptoms itself, it is a major risk factor for crippling ailments such as heart disease, kidney disease and stroke. And it is widely underdiagnosed and undertreated. This study will hopefully be yet another wake-up call to assist doctors urging their HBP patients to take their medications religiously, as many patients fear stroke more than heart attack, or even death.