PREVALENCE OF NONADHERENCE TO ANTI-HYPERTENSIVE THERAPY IN THE FIRST YEAR AFTER STROKE

Objective: Estimate the prevalence of nonadherence to anti-hypertensive treatment one year after stroke. Design and method: We conducted a retrospective non-blinded analysis to evaluate data from hypertensive patients admitted to a level B Stroke Unit between October 1, 2022, and September 30, 2023. Only patients admitted due to ischemic stroke, hemorrhagic stroke, or transient ischemic attack (TIA) were included. Patients who had deceased before November 2024 were excluded due to unavailability of data. To ensure adequate information on pill acquisition, we analyzed data from the national prescription software platform, focusing on purchases made within the 12 months following the event. We also collected information from the 18 months preceding the event purchases and estimated the non-adherence to treatment in the year prior to the event. We defined non-adherence as purchases lower than 82% of the doses expected in one year after stroke. Statistical analysis was performed using SPSS Statistics 23®. Results: One hundred and twenty-six patients were included, 95 for ischemic stroke, 22 for hemorrhagic stroke and 9 for TIA. Thirty-four patients were excluded due to death, absence of medication/new diagnosis or missing data. Sixty-two were female (49.21%), the mean age was 73.5 years (±11.3) and 47.6% (n=60) had previous hypertension mediated organ damage (HMOD). Seventy-three (57.9%) were treated with more than one anti-hypertensive drug but only 33 (26.9%) were treated with poly-pill combinations. Eighty-six (68.8%) did not adhere to anti-hypertension treatment in the year previous to the event while 37 (29.4%) of patients did not adhere in the year after the event. In multivariate analysis, an increased number of prescribed antihypertensive medications was significantly associated with non-adherence to antihypertensive treatment (OR 0.532, p=0.027, 95% CI 0.304–0.930). Additionally, it was found to be inversely associated with improvements in adherence (OR 0.505, p=0.041, 95% CI 0.263–0.972). Conclusions: Non-adherence to anti-hypertensive treatment reduced after a cerebrovascular event, but remained suboptimal. Higher number of prescribed antihypertensive medications was significantly associated with non-adherence and inversely associated with improvements in adherence. This highlights the need for tailored interventions to manage polypharmacy and enhance compliance.