Compliance to treatment and its role in solving the problem of uncontrolled hypertension
https://doi.org/10.15829/1728-8800-2023-3547
Abstract
Failure to achieve blood pressure targets and insufficient control are important cardiology problems that remain relevant despite well-defined and generally available modern algorithms for the treatment of hypertension (HTN) and the availability of effective antihypertensive drugs. The level of hypertension control in Russia remains quite low and is 14,1% for men and 30,9% for women. The generally recognized most important factor determining the low blood pressure control is non-compliance with antihypertensive therapy, which, in turn, determines the high percentage of uncontrolled HTN among patients. The review discusses the most common causes of low adherence to treatment. Particular attention is paid to the doctor’s ability to remove barriers to adherence and errors in the choice of therapy, including insufficient prescribing of fixed-dose combinations. The review presents a modern view on the significance of combined antihypertensive therapy. Attention is focused on fixed-dose combinations of antihypertensives, the use of which significantly increases adherence to therapy, and the unique properties and effectiveness of lisinopril, amlodipine and indapamide are described.
About the Authors
V. I. PodzolkovRussian Federation
Moscow
A. E. Bragina
Russian Federation
Moscow
I. D. Medvedev
Russian Federation
Moscow
M. V. Vetluzhskaya
Russian Federation
Moscow
A. A. Abramova
Russian Federation
Moscow
I. Zh. Loria
Russian Federation
Moscow
N. K. Megeneishvili
Russian Federation
Moscow
A. V. Sutulova
Russian Federation
Moscow
References
1. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957-80. doi:10.1016/S0140-6736(21)01330-1.
2. Boytsov SA, Balanova YuA, Shalnova SA, et al. Arterial hypertension among individuals of 25-64 years old: prevalence, awareness, treatment and control. By The Data from ECCD. Cardiovascular Therapy and Prevention. 2014;13(4):4-14. (In Russ.) doi:10.15829/1728-8800-2014-4-4-14.
3. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics — 2023 Update: A Report from the American Heart Association. Circulation. Circulation. 2023;147:e93-e621. doi:10.1161/CIR.0000000000001123.
4. Weldegiorgis M, Woodward M. The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis. BMC Nephrol. 2020;21:506. doi:10.1186/s12882-020-02151-7.
5. Zhou Y, Yang Q, Chi J, et al. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020;99:47-56. doi:10.1016/j.ijid.2020.07.029.
6. Williams B, Mancia G, Spiering W, et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2018;36(12):2284-309. doi:10.1093/eurheartj/ehy339.
7. Kobalava ZD, Konradi AO, Nedogoda SV, et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020;25(3):3786. (In Russ.) doi:10.15829/1560-4071-2020-3-3786.
8. Burnier M, Egan BM. Adherence in Hypertension. Circ Res. 2019;124(7):1124-40. doi:10.1161/CIRCRESAHA.118.313220.
9. Abegaz TM, Shehab A, Gebreyohannes EA, et al. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(4):e5641. doi:10.1097/MD.0000000000005641.
10. Podzolkov VI, Bragina AE, Natkina DU, et al. The Vascular Wall State and Microcirculation Parameters in Patients with Controlled and Uncontrolled Arterial Hypertension. Rational Pharmacotherapy in Cardiology. 2019;15(4):495-501. (In Russ.) doi:10.20996/1819-6446-2019-15-4-495-501.
11. Podzolkov VI, Bragina AE, Natkina DU, et al. Vascular markers of cognitive dysfunction in patients with uncontrolled arterial hypertension. Sechenov Medical Journal. 2020;11(3):26-36. (In Russ.) doi:10.47093/2218-7332.2020.11.3.26-36.
12. World Health Organization. Adherence to Long Term Therapies: Evidence for Action; Geneva: World Health Organization, 2003. ISBN: 9241545992.
13. Shalnova SA, Konradi AО, Balanova YuA, et al. What factors do influence arterial hypertension control in Russia. Cardiovascular Therapy and Prevention. 2018;17(4):53-60. (In Russ.) doi:10.15829/1728-8800-2018-4-53-60.
14. Lee EKP, Poon P, Yip BHK, et al. Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27 Million Patients. J Am Heart Assoc. 2022;11(17):e026582. doi:10.1161/JAHA.122.026582.
15. Aitini E, Martignoni G, Labianca R, et al. Communication Models for Doctor-Patient Relationships. J Canc Educ. 2014;29:211-2. doi:10.1007/s13187-014-0616-z.
16. Mallia P. The Nature of the Doctor-Patient Relationship. Health Care Principles Through the Phenomenology of Relationships with Patients. Springer. 2013. ISSN 2211-8101. ISBN: 978-94-007-4938-2. doi:10.1007/978-94-007-4939-9.
17. Vrijens B, Antoniou S, Burnier M, et al. Current Situation of Medication Adherence in Hypertension. Front Pharmacol. 2017;8:100. doi:10.3389/fphar.2017.00100.
18. Dalal JJ, Kerkar P, Guha S, et al. Therapeutic adherence in hypertension: Current evidence and expert opinion from India. Indian Heart J. 2021;73(6):667-73. doi:10.1016/j.ihj.2021.09.003.
19. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066.
20. Podzolkov VI, Bragina AE, Osadchiy KK. Resistant Hypertension: Questions and Contemporary Answers. Rational Pharmacotherapy in Cardiology 2019;15(4):568-77. (In Russ.) doi:10.20996/1819-6446-2019-15-4-568-577.
21. Parati G, Lombardi C, Pengo M, et al Current challenges for hypertension management: From better hypertension diagnosis to improved patients’ adherence and blood pressure control. Intern J Cardiol. 2021;331:262-9. doi:10.1016/j.ijcard.2021.01.070.
22. Gupta P, Patel P, Štrauch B, et al. Biochemical Screening for Nonadherence Is Associated With Blood Pressure Reduction and Improvement in Adherence. Hypertension. 2017;70(5):1042-8. doi:10.1161/HYPERTENSIONAHA.117.09631.
23. Hagendorff A, Freytag S, Müller A, et al. Pill burden in hypertensive patients treated with single-pill combination therapy — an observational study. Adv Ther. 2013;30(4):406-19. doi:10.1007/s12325-013-0018-3.
24. Jamerson K, Weber MA, Bakris GL, et al. ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008;359(23):2417-28. doi:10.1056/NEJMoa0806182.
25. Parati G, Kjeldsen S, Coca A, et al. Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension. A Systematic Review and Meta-Analysis. Hypertension. 2021;77(2):692-705. doi:10.1161/HYPERTENSIONAHA.120.15781.
26. Jaffe MG, Lee GA, Young JD, et al. Improved blood pressure control associated with a large-scale hypertension program. JAMA. 2013;310(7):699-705. doi:10.1001/jama.2013.108769.
27. Kizilirmak P, Berktas M, Uresin Y, et al. The efficacy and safety of triple vs dual combination of angiotensin II receptor blocker and calcium channel blocker and diuretic: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2013;15(3):193-200. doi:10.1111/jch.12040.
28. Semple PF, Cumming AM, Meredith PA, et al. Onset of action of captopril, enalapril, enalaprilic acid and lisinopril in normal man. Cardiovasc Drugs Ther. 1987;1(1):45-50. doi:10.1007/BF02125832.
29. Fares H, DiNicolantonio JJ, O’Keefe JH, et al. Amlodipine in hypertension: a first-line agent with efficacy for improving blood pressure and patient outcomes. Open Heart. 2016;3:e000473. doi:10.1136/openhrt-2016-000473.
30. Ferrario CM. Cardiac remodelling and RAS inhibition. Ther Adv Cardiovasc Dis. 2016;10(3):162-71. doi:10.1177/1753944716642677.
31. Lancaster SG, Todd PA. Lisinopril. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and congestive heart failure. Drugs. 1988;35(6):646-69. doi:10.2165/00003495-198835060-00003.
32. Langtry HD, Markham A. Lisinopril. A review of its pharmacology and clinical efficacy in elderly patients. Drugs Aging. 1997;10(2):131-66. doi:10.2165/00002512-199710020-00006.
33. Podzolkov VI, Tarzimanova AI. Lizinopril in the Treatment of Arterial Hypertension. Kardiologiia. 2017;57(9):77-82. (In Russ.) doi:10.18087/cardio.2017.9.10031.
34. Mancia G, Zanchetti A, Agabiti-Rosei E, et al. Study on monitoring of blood pressure and lisinopril evaluation. Circulation. 1997; 95(6);1464-70. doi:10.1161/01.cir.95.6.1464.
35. Shimamoto H, Shimamoto Y. Lisinopril reverses left ventricular hypertrophy through improved aortic compliance. Hypertension. 1996;28(3):457-63. doi:10.1161/01.hyp.28.3.457.
36. Hernández D, Lacalzada J, Salido E, et al. Regression of left ventricular hypertrophy by lisinopril after renal transplantation: role of ACE gene polymorphism. Kidney Int. 2000;58(2):889-97. doi:10.1046/j.1523-1755.2000.00239.x.
37. Poulsen PL, Ebbehøj E, Mogensen CE. Lisinopril reduces albuminuria during exercise in low grade microalbuminuric Type 1 diabetic patients: a double blind randomized study. J Intern Med. 2001;249:433-40. doi:10.1046/j.1365-2796.2001.00821.x.
38. Scisciola L, Fontanella RA, Surina, et al. Potential Role of Lisinopril in Reducing Atherosclerotic Risk: Evidence of an Antioxidant Effect in Human Cardiomyocytes Cell Line. Front. Pharmacol. 2022;13:868365. doi:10.3389/fphar.2022.868365.
39. Roush GC, Kaur R, Ernst ME. Diuretics: A Review and Update. J Cardiovasc Pharmacol Ther. 2014;19(1):5-13. doi:10.1177/1074248413497257.
40. London G. Efficacy of indapamide 1.5 mg, sustained release, in the lowering of systolic blood pressure. J Hum Hypertens. 2004;18(2):9-14. doi:10.1038/sj.jhh.1001799.
41. Sassard J, Bataillard A, McIntyre H. An overview of the pharmacology and clinical efficacy of indapamide sustained release. Fundam Clin Pharmacol. 2005;19(6):637-45. doi:10.1111/j.1472-8206.2005.00377.x.
42. Weidmann P. Metabolic profile of indapamide sustained-release in patients with hypertension: data from three randomised double-blind studies. Drug Saf. 2001;24(15):1155-65. doi:10.2165/00002018-200124150-00006.
43. Wang S, Li J, Zhou X, et al. Comparison between the effects of hydrochlorothiazide and indapamide on the kidney in hypertensive patients inadequately controlled with losartan. J Hum Hypertens. 2017;31(12):848-54. doi:10.1038/jhh.2017.51.
44. Marre M, Puig JG, Kokot F, et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR Study. J Hypertens. 2004;22(8):1613-22. doi:10.1097/01.hjh.0000133733.32125.09.
45. Beckett NS, Peters R, Fletcher AE, et al. HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887-98. doi:10.1056/NEJMoa0801369.
46. Chalmers J, Mourad JJ, De Champvallins M, et al. Benefit of indapamide-based treatment on mortality: a systematic review and meta-analysis. J Hypertens. 2019;37:e57. doi:10.1097/01.hjh.0000570928.33807.a8.
47. Meurin P. The ASCOT trial: clarifying the role of ACE inhibition in the reduction of cardiovascular events in patients with hypertension. Am J Cardiovasc Drugs. 2006;6(5):327-34. doi:10.2165/00129784-200606050-00005.
48. Nedogoda SV, Sanina TN, Tsoma VV, et al. Optimal Organ Protection and Blood Pressure Control with the Single Pill Combination Lisinopril, Amlodipine and Indapamide in Arterial Hypertension. Rational Pharmacotherapy in Cardiology. 2020;16(6):931-7. (In Russ.) doi:10.20996/1819-6446-2020-11-03.
Supplementary files
What is already known about the subject?
- Despite the achievements of modern cardiology and the availability of antihypertensive drugs, the current population of patients with hypertension (HTN) is characterized by low compliance.
- Increasing adherence to treatment depends on many factors that should be considered when choosing a strategy for treating HTN.
What might this study add?
- Increasing adherence can be achieved by a set of measures, the most accessible of which is the use of fixed-dose combinations, which reduce the number of drugs taken separately.
- An algorithm for the treatment and diagnosis of uncontrolled hypertension was proposed based on the generalization and analysis of modern ideas about overcoming low adherence.
Review
For citations:
Podzolkov V.I., Bragina A.E., Medvedev I.D., Vetluzhskaya M.V., Abramova A.A., Loria I.Zh., Megeneishvili N.K., Sutulova A.V. Compliance to treatment and its role in solving the problem of uncontrolled hypertension. Cardiovascular Therapy and Prevention. 2023;22(4):3547. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3547