Factors influencing adherence to treatment in older adults with hypertension

Figures & data

Table 1 The clinical and sociodemographic characteristics of study patients

Variables	Mean (SD)	Median (quartiles)
Age (years)	72.19 (8)	69 (65–78)
SBP (mmHg)	141.84 (17.21)	140 (130–150)
DBP (mmHg)	85.08 (12.99)	90 (80–90)
BMI (kg/m^2)	27.96 (5.63)	27.38 (24.8–30.79)
Duration of disease (years)	14.55 (9.39)	15 (7–18)
Features	n	%
Sex
Female	84	56.00
Male	66	44.00
Marital status
Married or living together	78	52.00
Single or divorced	11	7.33
Widowed	61	40.67
Education
Primary or none	51	34.00
Secondary	56	37.33
Vocational or higher	43	28.67
Occupational activity
Employed	34	22.67
Retired	100	66.67
Annuitant	16	10.67
Living arrangement
Living alone or in an organized institution	52	34.67
Living with family	98	65.33
JNC classification of HT
Prehypertension	38	25.33
Stage I HT	81	54.00
Stage II HT	31	20.67
Smoking
Non-smoker	112	74.67
Ex-smoker	25	16.67
Smoker	13	8.67
Alcohol
Abstinent	95	63.33
Non-abstinent	55	36.67
Comorbidities*
Diabetes	80	53.33
Hypercholesterolemia	48	32.00
Coronary artery disease	46	30.67
Renal failure	20	13.33
Rheumatic diseases	25	16.67
Medications administration*
AA	6	4.00
BA	44	29.33
CCB	42	28.00
ARB	11	7.33
TD	57	38.00
ACEI	102	68.00
Therapy
Monotherapy	67	44.67
Polytherapy	83	55.33

Note:

* Multiple choice questions, percentages do not add up to 100%.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; BMI, body mass index; CCB, calcium channel blocker; HT, hypertension; JNC, Joint National Committee; n, number of patients; TD, thiazide diuretic.

Table 2 Total score of the Hill-Bone CHBPTS

Total score of Hill-Bone CHBPTS (n=150)
Mean	SD	Median	Min	Max	Q1	Q3
20.19	4.05	19	14	32	17	22

Abbreviations: Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; Max, maximum value; Min, minimum value; n, number of patients; Q1, first quartile; Q3, third quartile.

Table 3 Results for subscales of the Hill-Bone CHBPTS

Hill-Bone CHBPTS subscale (n=150)	Mean	SD	Median	Min	Max	Q1	Q3
Reduced sodium intake	4.82	1.09	5	3	8	4	5
Appointment keeping	3.33	1.19	3	2	6	2	4
Medication taking	12.05	3.08	11	9	24	10	14

Abbreviations: Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; Max, maximum value; Min, minimum value; n, number of patients; Q1, first quartile; Q3, third quartile.

Table 4 Correlations demographic and clinical factors (quantitative) with the Hill-Bone CHBPTS

Hill-Bone CHBPTS	Correlation coefficient with**
	Age	SBP	DBP	BMI	Duration of disease
Total score	0.51*	−0.03	−0.13	−0.21*	0.30*
Reduced sodium intake	0.04	0.06	−0.09	0.01	0.01
Appointment keeping	0.32*	−0.05	−0.08	−0.07	0.25*
Medication taking	0.50*	−0.06	−0.12	−0.27*	0.28*

Notes:

* Statistical significance for P<0.05.

** Spearman’s rank correlation coefficient (non-normal distributions of correlated variables).

Abbreviation: BMI, body mass index; Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale.

Table 5 Results for demographic and clinical factors (qualitative)

Group	Total score	Reduced sodium intake	Appointment keeping	Medication taking
Female	19 (17–22)	5 (4–5)	3 (2–4)	11 (10–13.25)
Male	20 (18–23)	5 (5–6)	3.5 (2–4)	11.5 (10–14)
P-value*	0.22	0.01	0.71	0.36
Married or living together (A)	18 (16.25–20)	5 (4–5)	3 (2–4)	10 (9–12)
Single or divorced (B)	20 (18–21.5)	5 (4.5–5)	3 (2.5–4)	12 (10.5–12.5)
Widowed (C)	22 (19–23)	5 (4–5)	4 (3–4)	13 (10–15)
P-value*	<0.001	0.752	0.04	<0.001
Post hoc**	C>A	–	C>A	C>A
Primary or none (A)	22 (18–24.5)	5 (4–6)	3 (2–4)	13 (10–15)
Secondary (B)	20 (18–22)	5 (4–5)	4 (3–4)	11 (10–13)
Vocational or higher (C)	18 (16–19)	5 (4–5)	2 (2–4)	10 (9–11)
P-value*	<0.00	0.38	0.01	<0.00
Post hoc**	A.B>C	–	A.B>C	A>B>C
Employed (A)	18 (16–20)	5 (4–6)	2.5 (2–3.75)	10 (9–11.75)
Retired (B)	20 (18–23)	5 (4–5)	4 (2–4)	12 (10–14)
Annuitant (C)	19 (17.75–22)	5 (4.75–5)	3 (2–4)	11.5 (9.75–13)
P-value*	0.06	0.43	0.02	0.03
Post hoc**	–	–	B>A	B>A
Living alone or in an organized institution (A)	22 (19–24)	5 (4–5)	4 (3–5)	13 (10–15)
Living with family (B)	18 (17–21)	5 (4–5.75)	3 (2–4)	11 (9–12.75)
P-value*	<0.00	0.79	<0.00	<0.00
Prehypertension (A)	19 (16–22.75)	4.5 (4–5)	3 (2–4)	11 (10–13)
Stage I HT (B)	20 (18–23)	5 (4–5)	3 (2–4)	12 (10–14)
Stage II HT (C)	18 (17–20)	5 (4–5)	3 (2–4)	10 (9–12)
P-value*	0.043	0.164	0.808	0.025
Post hoc**	B>C	–	–	B>C
Non-smoker	20 (18–23)	5 (4–5)	3 (2–4)	11 (10–14)
Ex-smoker	18 (17–21)	5 (4–5)	3 (2–4)	10 (9–13)
Smoker	18 (17–20)	5 (4–6)	3 (2–4)	10 (9–12)
P-value*	0.066	0.127	0.456	0.052
Post hoc**	–	–	–	–
Abstinent	20 (17–22)	5 (4–5)	3 (2–4)	11 (10–14)
Non-abstinent	19 (17–22)	5 (4–6)	3 (2–4)	11 (10–12.5)
P-value*	0.31	0.18	0.06	0.35
Lack of diabetes	19 (17–22)	5 (4–5)	3 (2–4)	11 (9–14)
Diabetes	20 (18–23)	5 (4–5.25)	3 (2–4)	11 (10–14)
P-value*	0.46	0.46	0.37	0.28
Lack of hypercholesterolemia	19 (17–23)	5 (4–5)	3 (2–4)	11 (10–14)
Hypercholesterolemia	20 (18.75–22)	5 (4–5.25)	4 (3–5)	11 (10–13)
P-value*	0.09	0.5	<0.00	0.95
Lack of coronary artery disease	18 (17–22)	5 (4–5)	3 (2–4)	11 (9–13)
Coronary artery disease	21 (19–23)	5 (4–5)	4 (3–5)	13 (10–14)
P-value*	0.00	0.78	0.01	0.01
Lack of renal failure	19.5 (17–22.75)	5 (4–5)	3 (2–4)	11 (10–14)
Renal failure	19 (17.75–22)	4.5 (4–5.25)	3 (3–4)	10.5 (9–14)
P-value*	0.72	0.34	0.55	0.51
Lack of rheumatic diseases	19 (17–22)	5 (4–5)	3 (2–4)	11 (10–14)
Rheumatic diseases	21 (18–22)	5 (4–5)	3 (3–5)	12 (10–13)
P-value*	0.32	0.66	0.33	0.62
Lack of AA	20 (17–22.25)	5 (4–5)	3 (2–4)	11 (10–14)
AA	18 (18–18.75)	5 (5–5)	2 (2–2.75)	11 (10.25–11.75)
P-value*	0.23	0.6	0.03	0.53
Lack of BA	20 (17–23)	5 (4–5)	3 (2–4)	11 (10–14)
BA	19 (17.75–22)	5 (4–6)	3 (2–4)	11 (10–13.25)
P-value*	0.47	0.87	0.08	0.66
Lack of CCB	19.5 (17–22)	5 (4–5)	3 (2–4)	11 (10–14)
CCB	19 (17.25–22)	5 (4–5)	3 (2–4)	12 (10–13)
P-value*	0.95	0.69	0.49	0.99
Lack of ARB	19 (17–22)	5 (4–5)	3 (2–4)	11 (10–14)
ARB	23 (17.5–25.5)	5 (4–5.5)	4 (3–4)	14 (10–16)
P-value*	0.17	0.81	0.4	0.14
Lack of TD	19 (17–21)	5 (4–5)	3 (2–4)	10 (9–13)
TD	22 (18–24)	5 (4–5)	4 (2–4)	13 (11–15)
P-value*	<0.00	0.32	0.17	<0.00
Lack of ACEI	20 (18–23)	5 (4–6)	3 (2–4)	12 (10–14)
ACEI	19 (17–22)	5 (4–5)	3 (2–4)	11 (9.25–13.75)
P-value*	0.15	0.25	0.71	0.13
Monotherapy	19 (17–21)	5 (4–5)	3 (2–4)	10 (10–13)
Polytherapy	20 (18–23.5)	5 (4–5)	3 (2–4)	12 (10–14)
P-value*	0.08	0.54	0.40	0.04

Notes: Data are represented as median (Q1–Q3).

* Mann–Whitney test and Kruskal–Wallis test.

** The Dunn test (results for post hoc analysis). P, level of statistical significance. –, no relationship in post hoc analyses between A, B, and C for reduced sodium intake subscale.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; CCB, calcium channel blocker; HT, hypertension; Q1, first quartile; Q1, third quartile; TD, thiazide diuretic.

Table 6 Results of multivariate analyses for general results of the Hill-Bone CHBPTS

Variable	Coefficient	95% CI		P-value
Age (years)	0.20	0.08	0.32	<0.01
SBP (mmHg)	−0.01	−0.07	0.04	0.58
DBP (mmHg)	−0.02	−0.08	0.04	0.56
BMI (kg/m^2)	−0.03	−0.15	0.09	0.62
Duration of disease (years)	0.00	−0.08	0.07	0.95
Sex
Female=0
Male=1	1.34	0.08	2.60	0.04
Marital status
Single, divorced, or widowed=0
Married or living together=1	0.89	−0.94	2.71	0.34
Education
Primary or none=0
Secondary, vocational, or higher=1	−1.75	−3.22	−0.28	0.02
Occupational activity
Employed or annuitant=0
Retired=1	−0.50	−1.79	0.80	0.45
Living arrangement
Living alone or in an organized institution=0
Living with family=1	−1.91	−3.56	−0.26	0.02
JNC classification of HT
Prehypertension=0
Stage I or II HT=1	0.29	−1.30	1.89	0.72
Smoking
Non-smoker=0
Smoker or ex-smoker=1	−1.08	−2.49	0.32	0.13
Alcohol
Abstinent=0
Non-abstinent=1	1.08	−0.31	2.47	0.13
Diabetes
No=0
Yes=1	0.98	−0.26	2.23	0.12
Hypercholesterolemia
No=0
Yes=1	0.56	−0.77	1.89	0.41
Coronary artery disease
No=0
Yes=1	0.45	−1.13	2.02	0.58
Renal failure
No=0
Yes=1	−0.13	−1.96	1.71	0.89
Rheumatic diseases
No=0
Yes=1	0.95	−0.68	2.58	0.25
Alpha-adrenolytic
No=0
Yes=1	0.12	−1.42	1.65	0.88
BA
No=0
Yes=1	−0.91	−4.16	2.33	0.58
CCB
No=0
Yes=1	−0.01	−1.63	1.62	0.99
ARB
No=0
Yes=1	0.84	−1.00	2.69	0.37
TD
No=0
Yes=1	1.56	−1.41	4.52	0.30
ACEI
No=0
Yes=1	1.20	−0.58	2.98	0.19
Therapy
Monotherapy=0
Polytherapy=1	0.24	−1.60	2.07	0.80

Note: P, level of statistical significance.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; BMI, body mass index; CCB, calcium channel blocker; Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; HT, hypertension; JNC, Joint National Committee; TD, thiazide diuretic.

Table 7 Results of multivariate analyses for reduced sodium intake subscale of the Hill-Bone CHBPTS

Variables	Coefficient	95% CI		P-value
Age (years)	−0.01	−0.04	0.03	0.78
SBP (mmHg)	0.00	−0.01	0.02	0.87
DBP (mmHg)	−0.02	−0.04	0.00	0.02
BMI (kg/m^2)	0.02	−0.02	0.05	0.35
Duration of disease (years)	0.01	−0.02	0.03	0.56
Sex
Female=0
Male=1	0.36	−0.02	0.75	0.07
Marital status
Single, divorced, or widowed=0
Married or living together=1	−0.46	−1.02	0.10	0.11
Education
Primary or none=1
Secondary, vocational or higher=1	−0.31	−0.76	0.14	0.18
Occupational activity
Employed or annuitant=0
Retired=1	−0.44	−0.84	−0.04	0.03
Living arrangement
Living alone or in an organized institution=0
Living with family=1	0.34	−0.17	0.85	0.19
JNC classification of HT
Prehypertension=0
Stage I or II HT=1	0.44	−0.05	0.93	0.08
Smoking
Non-smoker=0
Smoker or ex-smoker=1	−0.18	−0.61	0.25	0.42
Alcohol
Abstinent=0
Non-abstinent=1	0.29	−0.14	0.71	0.19
Diabetes
No=0
Yes=1	0.34	−0.04	0.72	0.08
Hypercholesterolemia
No=0
Yes=1	0.27	−0.14	0.68	0.19
Coronary artery disease
No=0
Yes=1	0.17	−0.31	0.65	0.49
Renal failure
No=0
Yes=1	−0.18	−0.74	0.38	0.53
Rheumatic diseases
No=0
Yes=1	0.13	−0.37	0.63	0.61
Alpha-adrenolytic
No=0
Yes=1	−0.01	−0.48	0.46	0.97
BA
No=0
Yes=1	0.26	−0.74	1.25	0.61
CCB
No=0
Yes=1	0.27	−0.22	0.77	0.28
ARB
No=0
Yes=1	0.52	−0.04	1.09	0.07
TD
No=0
Yes=1	0.23	−0.68	1.14	0.62
ACEI
No=0
Yes=1	0.65	0.11	1.20	0.02
Therapy
Monotherapy=0
Polytherapy=1	0.10	−0.46	0.67	0.72

Note: P, level of statistical significance.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting-enzyme inhibitor; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; BMI, body mass index; CCB, calcium channel blocker; Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; HT, hypertension; JNC, Joint National Committee; TD, thiazide diuretic.

Table 8 Results of multivariate analyses for appointment keeping subscale of the Hill-Bone CHBPTS

Variables	Coefficient	95% CI		P-value
Age (years)	0.04	0.01	0.08	0.03
SBP (mmHg)	0.00	−0.02	0.02	0.93
DBP (mmHg)	0.00	−0.02	0.02	1.00
BMI (kg/m^2)	0.00	−0.04	0.04	0.96
Duration of disease (years)	−0.01	−0.03	0.02	0.56
Sex
Female=0
Male=1	0.42	0.03	0.81	0.04
Marital status
Single, divorced, or widowed=0
Married or living together=1	0.63	0.07	1.19	0.03
Education
Primary or none=1
Secondary, vocational or higher=1	0.25	−0.20	0.70	0.27
Occupational activity
Employed or annuitant=0
Retired=1	0.13	−0.26	0.53	0.51
Living arrangement
Living alone or in an organized institution=0
Living with family=1	−1.01	−1.51	−0.50	<0.01
JNC classification of HT
Prehypertension=0
Stage I or II HT=1	−0.08	−0.57	0.41	0.74
Smoking
Non-smoker=0
Smoker or ex-smoker=1	−0.17	−0.60	0.27	0.45
Alcohol
Abstinent=0
Non-abstinent=1	−0.30	−0.72	0.13	0.17
Diabetes
No=0
Yes=1	0.26	−0.12	0.64	0.18
Hypercholesterolemia
No=0
Yes=1	0.81	0.41	1.22	<0.01
Coronary artery disease
No=0
Yes=1	−0.10	−0.59	0.38	0.67
Renal failure
No=0
Yes=1	0.27	−0.29	0.84	0.34
Rheumatic diseases
No=0
Yes=1	0.27	−0.23	0.77	0.29
Alpha-adrenolytic
No=0
Yes=1	−0.17	−0.64	0.31	0.49
BA
No=0
Yes=1	−1.27	−2.27	−0.28	0.01
CCB
No=0
Yes=1	−0.64	−1.13	−0.14	0.01
ARB
No=0
Yes=1	−0.45	−1.01	0.12	0.12
TD
No=0
Yes=1	−0.13	−1.04	0.78	0.78
ACEI
No=0
Yes=1	−0.30	−0.85	0.25	0.28
Therapy
Monotherapy=0
Polytherapy=1	−0.40	−0.96	0.17	0.17

Note: P, level of statistical significance.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting-enzyme inhibitor; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; BMI, body mass index; CCB, Calcium channel blocker; Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; HT, hypertension; JNC, Joint National Committee; TD, thiazide diuretic.

Table 9 Results of multivariate analyses for medication taking subscale of the Hill-Bone CHBPTS

Variables	Coefficient	95% CI		P-value
Age (years)	0.16	0.07	0.25	<0.01
SBP (mmHg)	−0.02	−0.05	0.02	0.45
DBP (mmHg)	0.00	−0.04	0.05	0.87
BMI (kg/m^2)	−0.05	−0.14	0.04	0.29
Duration of disease (years)	0.00	−0.06	0.06	0.93
Sex
Female=0
Male=1	0.56	−0.39	1.50	0.25
Marital status
Single, divorced, or widowed=0
Married or living together=1	0.72	−0.65	2.09	0.30
Education
Primary or none=1
Secondary, vocational, or higher=1	−1.69	−2.80	−0.59	<0.01
Occupational activity
Employed or annuitant=0
Retired=1	−0.19	−1.17	0.78	0.69
Living arrangement
Living alone or in an organized institution=0
Living with family=1	−1.24	−2.49	0.00	0.05
JNC classification of HT
Prehypertension=0
Stage I or II HT=1	−0.07	−1.26	1.13	0.92
Smoking
Non-smoker=0
Smoker or ex-smoker=1	−0.74	−1.79	0.32	0.17
Alcohol
Abstinent=0
Non-abstinent=1	1.09	0.05	2.13	0.04
Diabetes
No=0
Yes=1	0.39	−0.55	1.32	0.42
Hypercholesterolemia
No=0
Yes=1	−0.53	−1.52	0.47	0.30
Coronary artery disease
No=0
Yes=1	0.38	−0.80	1.56	0.53
Renal failure
No=0
Yes=1	−0.22	−1.60	1.16	0.75
Rheumatic diseases
No=0
Yes=1	0.56	−0.67	1.78	0.37
Alpha-adrenolytic
No=0
Yes=1	0.29	−0.86	1.44	0.62
BA
No=0
Yes=1	0.10	−2.33	2.54	0.93
CCB
No=0
Yes=1	0.35	−0.87	1.57	0.57
ARB
No=0
Yes=1	0.76	−0.62	2.15	0.28
TD
No=0
Yes=1	1.46	−0.78	3.69	0.20
ACEI
No=0
Yes=1	0.84	−0.50	2.18	0.21
Therapy
Monotherapy=0
Polytherapy=1	0.53	−0.85	1.91	0.45

Note: P, level of statistical significance.

Abbreviations: AA, alpha-adrenolytic; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; BA, beta-adrenolytic; BMI, body mass index; CCB, calcium channel blocker; Hill-Bone CHBPTS, Hill-Bone Compliance to High Blood Pressure Therapy Scale; HT, hypertension; JNC, Joint National Committee; TD, thiazide diuretic.