Suboptimal Adherence to Antihypertensive Treatment: Causes and Management

Stelina Alkagiet1, Konstantinos Tziomalos2
1 First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
2 First Propedeutic Department of Internal Medicine, AHEPA Hospital, 1 Stilponos Kyriakidi Street, Thessaloniki, 54636, Greece

© 2018 Alkagiet and Tziomalos.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Suboptimal adherence to antihypertensive treatment is very common and is associated with poor control of blood pressure and increased risk for cardiovascular events. Therefore, frequent evaluation of compliance is essential in all hypertensive patients. Simplifying treatment regimens, using fixed-dose combinations and long-acting agents improves adherence, facilitates achievement of treatment targets and reduces cardiovascular morbidity and healthcare expenditures. Accordingly, physicians should be educated to implement these changes in hypertensive patients, particularly in those who require multiple antihypertensive agents to achieve blood pressure controls and in those who receive additional medications for comorbidities.

Keywords: Hypertension, Adherence, Compliance, Fixed-dose combination, Cost, Cardiovascular morbidity, Compliance indices.