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

Kiyoshi Matsumura, Hisatomi 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 FukuharaYuko 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

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49 Citations (Scopus)


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
Pages (from-to)909-914
Number of pages6
Issue number10
Publication statusPublished - Oct 2013

All Science Journal Classification (ASJC) codes

  • General Medicine


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