Endocrine Abstracts

Introduction: High blood pressure (HBP) is a public health problem because it is a major cause of global morbidity and mortality. Antihypertensive therapy has evolved significantly in recent years to reduce the number of tablets to improve adherence therapy.

Purpose of our work: The purpose of our work was to estimate the risk of non-compliance with antihypertensive treatments for a population of hypertensive and diabetic patients, by using a validated calculator.

Patients and methods: This is a retrospective study that collects all hypertensive patients hospitalized in our department from December 2017 to January 2018. For the calculation of the risk of nonobservance, we used a validated calculator available online at http://www.comitehta.org/flahs-observance-hta/.

Results: We included 60 hospitalized hypertensive diabetic patients. The average age was 64.87 years with a s.d. of 9.99 years. The sex ratio was 2.1. All patients were diabetic treated with insulin. 43 patients were on both insulin and oral antidiabetic drugs. Hypercholesterolemia was noted in 80% of our patients (48). Coronary heart disease was noted in 20% of our patients (12). 37 patients were suffering from vision disorder: 10 patients are followed for cataract and 17 others are followed for diabetic retinopathy. The average number of tablets taken for HBP was 2.6 with a standard deviation of 0.93. Angiotensin converting enzyme inhibitors and calcium channel blockers are prescribed in respectively 80% and 43.3% of cases. The calculation of the risk of non-compliance concluded that 48.3% of our patients (29) had a high risk of non-compliance, 35% had an intermediate risk and only 17.7% had a low risk of non-compliance. The risk of high nonobservance was noted in 17 women and in 12 men with a significant difference (P=0.05). A number of tablets >3 alone is not correlated with a higher risk of non-compliance (Kappa=0.29). However, its association with retinopathy increases the risk of non-compliance (P=0.01).

Discussion and conclusion: The risk of nonobservance calculator is an easy, accessible and available tool, allowing the optimization of antihypertensive treatment according to the profile of the patients. Its use must be wider in order to better control the High blood pressure.