Impact of antihypertensive medication adherence on blood pressure control in hypertension: The COMFORT study

Kiyoshi Matsumura, H. Arima, M. Tominaga, Toshio Ohtsubo, Toshiyuki Sasaguri, K. Fujii, M. Fukuhara, K. Uezono, Y. Morinaga, Y. Ohta, T. Otonari, J. Kawasaki, I. Kato, T. Tsuchihashi, Takuya Tsuchihashi, Toshiyuki Sasaguri, Koji Fujii, Mitsuhiro Tominaga, Toshio Ohtsubo, Masayo FukuharaHisatomi Arima, Yuko Ohta, Takatoshi Otonari, Junya Kawasaki, Yuki Morinaga, Shuntaro Kagiyama, Tetsuhiko Nagao, Isao Kato, Yae Fujishima, Kimika Arakawa, Yuji Fukudome, Uran Onaka, Kenichi Goto, Yoshito Nakamura, Junpei Yamada, Kenichi Sugi, Koichi Arase, Toshiharu Kawadoko, Shin Nakamura, Keiichi Midorikawa, Kensuke Nomiyama, Toshihiko Hashimoto, Atsushi Murakami, Koichi Fukuda, Toshimitsu Soh, Akihiko Eshita, Morioki Ishibashi

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases. Aim: To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan Potassium and Hydrochlorothiazide for Improvement of Medication Compliance Trial (COMFORT) study. Design: An observational analysis from a randomized controlled trial. Methods: A total of 203 hypertensive subjects were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or two pills, an angiotensin II receptor blocker and a thiazide diuretic. Medication adherence calculated based on pill counts and BPs was evaluated at 1, 3 and 6 months after randomization. Results: The subjects were divided into three groups according to their adherence, i.e. relatively low-adherence (<90%; n = 19), moderate-adherence (90-99%; n = 71) and high-adherence (100%; n = 113) groups. Clinical characteristics of the subjects including BP, sex, randomized treatments and past medical history did not differ significantly among the three groups. Achieved follow-up BPs over the 6-month treatment period, which were adjusted for age, sex,baseline BP and randomized treatment, were significantly higher in the lowadherence group (135/78 mmHg) compared with the high-adherence (130/74 mmHg;P = 0.02/0.02) and the moderate-adherence (128/74 mmHg; P = 0.003/0.02) groups. Conclusions: Low adherence to an antihypertensivedrug regimen was associated with poor BP control.

Original languageEnglish
Article numberhct121
Pages (from-to)909-914
Number of pages6
JournalQJM
Volume106
Issue number10
DOIs
Publication statusPublished - Oct 1 2013

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Medication Adherence
Antihypertensive Agents
Blood Pressure
Hypertension
Sodium Chloride Symporter Inhibitors
Hydrochlorothiazide
Losartan
Angiotensin Receptor Antagonists
Random Allocation
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Matsumura, K., Arima, H., Tominaga, M., Ohtsubo, T., Sasaguri, T., Fujii, K., ... Ishibashi, M. (2013). Impact of antihypertensive medication adherence on blood pressure control in hypertension: The COMFORT study. QJM, 106(10), 909-914. [hct121]. https://doi.org/10.1093/qjmed/hct121

Impact of antihypertensive medication adherence on blood pressure control in hypertension : The COMFORT study. / Matsumura, Kiyoshi; Arima, H.; Tominaga, M.; Ohtsubo, Toshio; Sasaguri, Toshiyuki; Fujii, K.; Fukuhara, M.; Uezono, K.; Morinaga, Y.; Ohta, Y.; Otonari, T.; Kawasaki, J.; Kato, I.; Tsuchihashi, T.; Tsuchihashi, Takuya; Sasaguri, Toshiyuki; Fujii, Koji; Tominaga, Mitsuhiro; Ohtsubo, Toshio; Fukuhara, Masayo; Arima, Hisatomi; Ohta, Yuko; Otonari, Takatoshi; Kawasaki, Junya; Morinaga, Yuki; Kagiyama, Shuntaro; Nagao, Tetsuhiko; Kato, Isao; Fujishima, Yae; Arakawa, Kimika; Fukudome, Yuji; Onaka, Uran; Goto, Kenichi; Nakamura, Yoshito; Yamada, Junpei; Sugi, Kenichi; Arase, Koichi; Kawadoko, Toshiharu; Nakamura, Shin; Midorikawa, Keiichi; Nomiyama, Kensuke; Hashimoto, Toshihiko; Murakami, Atsushi; Fukuda, Koichi; Soh, Toshimitsu; Eshita, Akihiko; Ishibashi, Morioki.

In: QJM, Vol. 106, No. 10, hct121, 01.10.2013, p. 909-914.

Research output: Contribution to journalArticle

Matsumura, K, Arima, H, Tominaga, M, Ohtsubo, T, Sasaguri, T, Fujii, K, Fukuhara, M, Uezono, K, Morinaga, Y, Ohta, Y, Otonari, T, Kawasaki, J, Kato, I, Tsuchihashi, T, Tsuchihashi, T, Sasaguri, T, Fujii, K, Tominaga, M, Ohtsubo, T, Fukuhara, M, Arima, H, Ohta, Y, Otonari, T, Kawasaki, J, Morinaga, Y, Kagiyama, S, Nagao, T, Kato, I, Fujishima, Y, Arakawa, K, Fukudome, Y, Onaka, U, Goto, K, Nakamura, Y, Yamada, J, Sugi, K, Arase, K, Kawadoko, T, Nakamura, S, Midorikawa, K, Nomiyama, K, Hashimoto, T, Murakami, A, Fukuda, K, Soh, T, Eshita, A & Ishibashi, M 2013, 'Impact of antihypertensive medication adherence on blood pressure control in hypertension: The COMFORT study', QJM, vol. 106, no. 10, hct121, pp. 909-914. https://doi.org/10.1093/qjmed/hct121
Matsumura, Kiyoshi ; Arima, H. ; Tominaga, M. ; Ohtsubo, Toshio ; Sasaguri, Toshiyuki ; Fujii, K. ; Fukuhara, M. ; Uezono, K. ; Morinaga, Y. ; Ohta, Y. ; Otonari, T. ; Kawasaki, J. ; Kato, I. ; Tsuchihashi, T. ; Tsuchihashi, Takuya ; Sasaguri, Toshiyuki ; Fujii, Koji ; Tominaga, Mitsuhiro ; Ohtsubo, Toshio ; Fukuhara, Masayo ; Arima, Hisatomi ; Ohta, Yuko ; Otonari, Takatoshi ; Kawasaki, Junya ; Morinaga, Yuki ; Kagiyama, Shuntaro ; Nagao, Tetsuhiko ; Kato, Isao ; Fujishima, Yae ; Arakawa, Kimika ; Fukudome, Yuji ; Onaka, Uran ; Goto, Kenichi ; Nakamura, Yoshito ; Yamada, Junpei ; Sugi, Kenichi ; Arase, Koichi ; Kawadoko, Toshiharu ; Nakamura, Shin ; Midorikawa, Keiichi ; Nomiyama, Kensuke ; Hashimoto, Toshihiko ; Murakami, Atsushi ; Fukuda, Koichi ; Soh, Toshimitsu ; Eshita, Akihiko ; Ishibashi, Morioki. / Impact of antihypertensive medication adherence on blood pressure control in hypertension : The COMFORT study. In: QJM. 2013 ; Vol. 106, No. 10. pp. 909-914.
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abstract = "Background: It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases. Aim: To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan Potassium and Hydrochlorothiazide for Improvement of Medication Compliance Trial (COMFORT) study. Design: An observational analysis from a randomized controlled trial. Methods: A total of 203 hypertensive subjects were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or two pills, an angiotensin II receptor blocker and a thiazide diuretic. Medication adherence calculated based on pill counts and BPs was evaluated at 1, 3 and 6 months after randomization. Results: The subjects were divided into three groups according to their adherence, i.e. relatively low-adherence (<90{\%}; n = 19), moderate-adherence (90-99{\%}; n = 71) and high-adherence (100{\%}; n = 113) groups. Clinical characteristics of the subjects including BP, sex, randomized treatments and past medical history did not differ significantly among the three groups. Achieved follow-up BPs over the 6-month treatment period, which were adjusted for age, sex,baseline BP and randomized treatment, were significantly higher in the lowadherence group (135/78 mmHg) compared with the high-adherence (130/74 mmHg;P = 0.02/0.02) and the moderate-adherence (128/74 mmHg; P = 0.003/0.02) groups. Conclusions: Low adherence to an antihypertensivedrug regimen was associated with poor BP control.",
author = "Kiyoshi Matsumura and H. Arima and M. Tominaga and Toshio Ohtsubo and Toshiyuki Sasaguri and K. Fujii and M. Fukuhara and K. Uezono and Y. Morinaga and Y. Ohta and T. Otonari and J. Kawasaki and I. Kato and T. Tsuchihashi and Takuya Tsuchihashi and Toshiyuki Sasaguri and Koji Fujii and Mitsuhiro Tominaga and Toshio Ohtsubo and Masayo Fukuhara and Hisatomi Arima and Yuko Ohta and Takatoshi Otonari and Junya Kawasaki and Yuki Morinaga and Shuntaro Kagiyama and Tetsuhiko Nagao and Isao Kato and Yae Fujishima and Kimika Arakawa and Yuji Fukudome and Uran Onaka and Kenichi Goto and Yoshito Nakamura and Junpei Yamada and Kenichi Sugi and Koichi Arase and Toshiharu Kawadoko and Shin Nakamura and Keiichi Midorikawa and Kensuke Nomiyama and Toshihiko Hashimoto and Atsushi Murakami and Koichi Fukuda and Toshimitsu Soh and Akihiko Eshita and Morioki Ishibashi",
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T1 - Impact of antihypertensive medication adherence on blood pressure control in hypertension

T2 - The COMFORT study

AU - Matsumura, Kiyoshi

AU - Arima, H.

AU - Tominaga, M.

AU - Ohtsubo, Toshio

AU - Sasaguri, Toshiyuki

AU - Fujii, K.

AU - Fukuhara, M.

AU - Uezono, K.

AU - Morinaga, Y.

AU - Ohta, Y.

AU - Otonari, T.

AU - Kawasaki, J.

AU - Kato, I.

AU - Tsuchihashi, T.

AU - Tsuchihashi, Takuya

AU - Sasaguri, Toshiyuki

AU - Fujii, Koji

AU - Tominaga, Mitsuhiro

AU - Ohtsubo, Toshio

AU - Fukuhara, Masayo

AU - Arima, Hisatomi

AU - Ohta, Yuko

AU - Otonari, Takatoshi

AU - Kawasaki, Junya

AU - Morinaga, Yuki

AU - Kagiyama, Shuntaro

AU - Nagao, Tetsuhiko

AU - Kato, Isao

AU - Fujishima, Yae

AU - Arakawa, Kimika

AU - Fukudome, Yuji

AU - Onaka, Uran

AU - Goto, Kenichi

AU - Nakamura, Yoshito

AU - Yamada, Junpei

AU - Sugi, Kenichi

AU - Arase, Koichi

AU - Kawadoko, Toshiharu

AU - Nakamura, Shin

AU - Midorikawa, Keiichi

AU - Nomiyama, Kensuke

AU - Hashimoto, Toshihiko

AU - Murakami, Atsushi

AU - Fukuda, Koichi

AU - Soh, Toshimitsu

AU - Eshita, Akihiko

AU - Ishibashi, Morioki

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Background: It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases. Aim: To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan Potassium and Hydrochlorothiazide for Improvement of Medication Compliance Trial (COMFORT) study. Design: An observational analysis from a randomized controlled trial. Methods: A total of 203 hypertensive subjects were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or two pills, an angiotensin II receptor blocker and a thiazide diuretic. Medication adherence calculated based on pill counts and BPs was evaluated at 1, 3 and 6 months after randomization. Results: The subjects were divided into three groups according to their adherence, i.e. relatively low-adherence (<90%; n = 19), moderate-adherence (90-99%; n = 71) and high-adherence (100%; n = 113) groups. Clinical characteristics of the subjects including BP, sex, randomized treatments and past medical history did not differ significantly among the three groups. Achieved follow-up BPs over the 6-month treatment period, which were adjusted for age, sex,baseline BP and randomized treatment, were significantly higher in the lowadherence group (135/78 mmHg) compared with the high-adherence (130/74 mmHg;P = 0.02/0.02) and the moderate-adherence (128/74 mmHg; P = 0.003/0.02) groups. Conclusions: Low adherence to an antihypertensivedrug regimen was associated with poor BP control.

AB - Background: It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases. Aim: To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan Potassium and Hydrochlorothiazide for Improvement of Medication Compliance Trial (COMFORT) study. Design: An observational analysis from a randomized controlled trial. Methods: A total of 203 hypertensive subjects were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or two pills, an angiotensin II receptor blocker and a thiazide diuretic. Medication adherence calculated based on pill counts and BPs was evaluated at 1, 3 and 6 months after randomization. Results: The subjects were divided into three groups according to their adherence, i.e. relatively low-adherence (<90%; n = 19), moderate-adherence (90-99%; n = 71) and high-adherence (100%; n = 113) groups. Clinical characteristics of the subjects including BP, sex, randomized treatments and past medical history did not differ significantly among the three groups. Achieved follow-up BPs over the 6-month treatment period, which were adjusted for age, sex,baseline BP and randomized treatment, were significantly higher in the lowadherence group (135/78 mmHg) compared with the high-adherence (130/74 mmHg;P = 0.02/0.02) and the moderate-adherence (128/74 mmHg; P = 0.003/0.02) groups. Conclusions: Low adherence to an antihypertensivedrug regimen was associated with poor BP control.

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DO - 10.1093/qjmed/hct121

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JO - QJM - Monthly Journal of the Association of Physicians

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