It seems that one-third chronic kidney disease patients recommended therapies for high blood pressure often fail to follow treatments. Scientists from the University of Cincinnati and the Cincinnati Veterans Affairs (VA) Medical Center claim that by simply complying with the prescribed treatment for hypertension, chronic kidney disease patients can improve outcomes significantly. The disease known to gradually slow kidney function is correlated with ongoing hypertension.
Two year data of patients provided with ambulatory care was evaluated by the investigators. A total of 7,227 chronic kidney disease patients had received at least one blood pressure medication prescription. Outpatient blood pressure measurements were averaged as high with more than 130/80 mm of Hg versus normal. The calculations were done after keeping in mind the national guidelines for hypertension management in kidney disease. Throughout the study experts kept a tab on medication adherence with the help of medication possession ratio so, the actual treatment days were divided by the total number of treatment days.
Charuhas Thakar, MD, associate professor in the division of nephrology and hypertension at UC and chief of the renal section at the Cincinnati VA, alleged, “Hypertension, or high blood pressure, is probably the most important modifiable risk factor in chronic kidney disease—a precursor to end-stage renal disease that is associated with increased risk of morbidity and mortality. In chronic conditions, such as hypertension, whether or not a patient takes the correct dosage and amount of their hypertension medication is critical in reaching treatment goals. Patterns of medication adherence for these agents and their impact on blood pressure in practice settings were not previously well studied. We wanted to find out if medication adherence could make a difference on outcomes in kidney disease patients.”
Medication followers were compared to non/poor followers for differences in demographic, co-morbid and laboratory variables. It was pointed out that 67 percent patients took their medication properly and 33 percent of patients reported poor medication adherence. In the poor adherence group, 23 percent were supposedly more likely to have sub-optimal blood pressure control during the entire two-year study period. Additional investigations can be carried out to precisely examine the impact of medication adherence on cardiovascular and renal outcomes in practice.
The study was published in the November 2 online edition of the American Journal of Nephrology.