Skip to main content
SpringerLink
Log in

Determinants and Barriers to Adherence in Hypertension

  • Chapter
  • First Online:
Drug Adherence in Hypertension and Cardiovascular Protection

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

  • 765 Accesses

Abstract

Hypertension is a chronic disease which needs a lifelong treatment in mostly asympatomatic patients. During the life of a patient treated for essential hypertension, many obstacles may occur which impair his/her ability to stay on therapy. In this chapter, we will review the determinants and barriers to adherence in hypertension utilizing the WHO Multidimensional Adherence Model classification, showing in which phase of the adherence process they intervene. We will review how these barriers may complicate the therapeutic history of a hypertensive patient based on a clinical case.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ, Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002;360(9343):1347–60.

    Article  PubMed  Google Scholar 

  2. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281–357.

    Article  CAS  PubMed  Google Scholar 

  3. Burt VL, Cutler JA, Higgins M, Horan MJ, Labarthe D, Whelton P, et al. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension. 1995;26(1):60–9.

    Article  CAS  PubMed  Google Scholar 

  4. Reiner Z, Sonicki Z, Tedeschi-Reiner E. Physicians’ perception, knowledge and awareness of cardiovascular risk factors and adherence to prevention guidelines: the PERCRO-DOC survey. Atherosclerosis. 2010;213(2):598–603.

    Article  CAS  PubMed  Google Scholar 

  5. Amar J, Chamontin B, Genes N, Cantet C, Salvador M, Cambou JP. Why is hypertension so frequently uncontrolled in secondary prevention? J Hypertens. 2003;21(6):1199–205.

    Article  CAS  PubMed  Google Scholar 

  6. Mancia G, Ambrosioni E, Rosei EA, Leonetti G, Trimarco B, Volpe M, et al. Blood pressure control and risk of stroke in untreated and treated hypertensive patients screened from clinical practice: results of the ForLife study. J Hypertens. 2005;23(8):1575–81.

    Article  CAS  PubMed  Google Scholar 

  7. Costa FV. Compliance with antihypertensive treatment. Clin Exp Hypertens. 1996;18(3–4):463–72.

    Article  CAS  PubMed  Google Scholar 

  8. Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. Br Med J. 2008;336(7653):1114–7.

    Article  Google Scholar 

  9. Ascertaining barriers for compliance: policies for safe, effective and cost-effective use of medicines in Europe. 2012: 1–542 pp.

    Google Scholar 

  10. Rudd P. Clinicians and patients with hypertension: unsettled issues about compliance. Am Heart J. 1995;130(3 Pt 1):572–9.

    Article  CAS  PubMed  Google Scholar 

  11. World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.

    Google Scholar 

  12. Wang PS, Bohn RL, Knight E, Glynn RJ, Mogun H, Avorn J. Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med. 2002;17(7):504–11.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cummings KM, Kirscht JP, Binder LR, Godley AJ. Determinants of drug treatment maintenance among hypertensive persons in inner city Detroit. Public Health Rep. 1982;97(2):99–106.

    PubMed  PubMed Central  CAS  Google Scholar 

  14. Ryan AA. Medication compliance and older people: a review of the literature. Int J Nurs Stud. 1999;36(2):153–62.

    Article  CAS  PubMed  Google Scholar 

  15. Ogedegbe G, Mancuso CA, Allegrante JP, Charlson ME. Development and evaluation of a medication adherence self-efficacy scale in hypertensive African-American patients. J Clin Epidemiol. 2003;56(6):520–9.

    Article  PubMed  Google Scholar 

  16. Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. JAMA. 2002;288(22):2880–3.

    Article  PubMed  Google Scholar 

  17. Knight EL, Bohn RL, Wang PS, Glynn RJ, Mogun H, Avorn J. Predictors of uncontrolled hypertension in ambulatory patients. Hypertension. 2001;38(4):809–14.

    Article  CAS  PubMed  Google Scholar 

  18. Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol. 1985;4(2):115–35.

    Article  CAS  PubMed  Google Scholar 

  19. Sharkness CM, Snow DA. The patient's view of hypertension and compliance. Am J Prev Med. 1992;8(3):141–6.

    Article  CAS  PubMed  Google Scholar 

  20. Reach G, Guedj-Meynier D, Darne B, Herpin D. [Factors associated with medication non-adherence in uncontrolled hypertensive males and females: ODACE study]. Annales de cardiologie et d’angeiologie. 2015;64(3):222–6.

    Google Scholar 

  21. Boutin-Foster C, Ogedegbe G, Ravenell JE, Robbins L, Charlson ME. Ascribing meaning to hypertension: a qualitative study among African Americans with uncontrolled hypertension. Ethn Dis. 2007;17(1):29–34.

    PubMed  Google Scholar 

  22. DiMatteo MR, Haskard KB, Williams SL. Health beliefs, disease severity, and patient adherence: a meta-analysis. Med Care. 2007;45(6):521–8.

    Article  PubMed  Google Scholar 

  23. DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200–9.

    Article  PubMed  Google Scholar 

  24. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160(14):2101–7.

    Article  CAS  PubMed  Google Scholar 

  25. Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: a systematic review and meta-analysis. Medicine. 2017;96(4):e5641.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Holt E, Joyce C, Dornelles A, Morisky D, Webber LS, Muntner P, et al. Sex differences in barriers to antihypertensive medication adherence: findings from the cohort study of medication adherence among older adults. J Am Geriatr Soc. 2013;61(4):558–64.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gupta P, Patel P, Strauch B, Lai FY, Akbarov A, Maresova V, et al. Risk factors for nonadherence to antihypertensive treatment. Hypertension. 2017;69(6):1113–20.

    Article  CAS  PubMed  Google Scholar 

  28. Coons SJ, Sheahan SL, Martin SS, Hendricks J, Robbins CA, Johnson JA. Predictors of medication noncompliance in a sample of older adults. Clin Ther. 1994;16(1):110–7.

    PubMed  CAS  Google Scholar 

  29. Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez R. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol. 2001;166(2):569–74; discussion 74–5.

    Article  CAS  PubMed  Google Scholar 

  30. Grimm RH Jr, Grandits GA, Prineas RJ, McDonald RH, Lewis CE, Flack JM, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension. 1997;29(1 Pt 1):8–14.

    Article  CAS  PubMed  Google Scholar 

  31. Manolis A, Doumas M. Sexual dysfunction: the ‘prima ballerina’ of hypertension-related quality-of-life complications. J Hypertens. 2008;26(11):2074–84.

    Article  CAS  PubMed  Google Scholar 

  32. McLaughlin T, Harnett J, Burhani S, Scott B. Evaluation of erectile dysfunction therapy in patients previously nonadherent to long-term medications: a retrospective analysis of prescription claims. Am J Ther. 2005;12(6):605–11.

    Article  PubMed  Google Scholar 

  33. Siegel D, Lopez J, Meier J. Antihypertensive medication adherence in the Department of Veterans Affairs. Am J Med. 2007;120(1):26–32.

    Article  PubMed  Google Scholar 

  34. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Levin R, Avorn J. The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population-based study in the elderly. Am J Hypertens. 1997;10(7 Pt 1):697–704.

    Article  CAS  PubMed  Google Scholar 

  35. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Levin R, Avorn J. Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race. Am J Public Health. 1996;86(12):1805–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Perreault S, Lamarre D, Blais L, Dragomir A, Berbiche D, Lalonde L, et al. Persistence with treatment in newly treated middle-aged patients with essential hypertension. Ann Pharmacother. 2005;39(9):1401–8.

    Article  CAS  PubMed  Google Scholar 

  37. Bautista LE. Predictors of persistence with antihypertensive therapy: results from the NHANES. Am J Hypertens. 2008;21(2):183–8.

    Article  PubMed  Google Scholar 

  38. Caro JJ, Salas M, Speckman JL, Raggio G, Jackson JD. Persistence with treatment for hypertension in actual practice. CMAJ. 1999;160(1):31–7.

    PubMed  PubMed Central  CAS  Google Scholar 

  39. Piette JD, Heisler M, Wagner TH. Cost-related medication underuse among chronically ill adults: the treatments people forgo, how often, and who is at risk. Am J Public Health. 2004;94(10):1782–7.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Wilson IB, Rogers WH, Chang H, Safran DG. Cost-related skipping of medications and other treatments among Medicare beneficiaries between 1998 and 2000. Results of a national study. J Gen Intern Med. 2005;20(8):715–20.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Wilson IB, Schoen C, Neuman P, Strollo MK, Rogers WH, Chang H, et al. Physician-patient communication about prescription medication nonadherence: a 50-state study of America’s seniors. J Gen Intern Med. 2007;22(1):6–12.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Turner BJ, Hollenbeak C, Weiner MG, Ten Have T, Roberts C. Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients. Pharmacoepidemiol Drug Saf. 2009;18(8):672–81.

    Article  PubMed  Google Scholar 

  43. Gray SL, Mahoney JE, Blough DK. Medication adherence in elderly patients receiving home health services following hospital discharge. Ann Pharmacother. 2001;35(5):539–45.

    Article  CAS  PubMed  Google Scholar 

  44. Kivimaki M, Batty GD, Hamer M, Nabi H, Korhonen M, Huupponen R, et al. Influence of retirement on nonadherence to medication for hypertension and diabetes. CMAJ. 2013;185(17):E784–90.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Charles H, Good CB, Hanusa BH, Chang CC, Whittle J. Racial differences in adherence to cardiac medications. J Natl Med Assoc. 2003;95(1):17–27.

    PubMed  PubMed Central  Google Scholar 

  46. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121(7):948–54.

    Article  PubMed  Google Scholar 

  47. Sehgal AR. Overlap between whites and blacks in response to antihypertensive drugs. Hypertension. 2004;43(3):566–72.

    Article  CAS  PubMed  Google Scholar 

  48. Orth JE, Stiles WB, Scherwitz L, Hennrikus D, Vallbona C. Patient exposition and provider explanation in routine interviews and hypertensive patients’ blood pressure control. Health Psychol. 1987;6(1):29–42.

    Article  CAS  PubMed  Google Scholar 

  49. Briesacher BA, Gurwitz JH, Soumerai SB. Patients at-risk for cost-related medication nonadherence: a review of the literature. J Gen Intern Med. 2007;22(6):864–71.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Alsabbagh MH, Lemstra M, Eurich D, Lix LM, Wilson TW, Watson E, et al. Socioeconomic status and nonadherence to antihypertensive drugs: a systematic review and meta-analysis. Value Health. 2014;17(2):288–96.

    Article  PubMed  Google Scholar 

  51. Wright J, Lee C, Chambers G. Real-world effectiveness of antihypertensive drugs. Can Med Assoc J. 2000;162:190–1.

    Google Scholar 

  52. Hicks LS, Shaykevich S, Bates DW, Ayanian JZ. Determinants of racial/ethnic differences in blood pressure management among hypertensive patients. BMC Cardiovasc Disord. 2005;5(1):16.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Mehta SS, Wilcox CS, Schulman KA. Treatment of hypertension in patients with comorbidities: results from the study of hypertensive prescribing practices (SHyPP). Am J Hypertens. 1999;12(4 Pt 1):333–40.

    CAS  PubMed  Google Scholar 

  54. Wang L. Physician-related barriers to hypertension management. Med Princ Pract. 2004;13(5):282–5.

    Article  PubMed  Google Scholar 

  55. Lebeau JP, Cadwallader JS, Aubin-Auger I, Mercier A, Pasquet T, Rusch E, et al. The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review. BMC Fam Pract. 2014;15:130.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Phillips LS, Branch WT, Cook CB, Doyle JP, El-Kebbi IM, Gallina DL, et al. Clinical inertia. Ann Intern Med. 2001;135(9):825–34.

    Article  CAS  PubMed  Google Scholar 

  57. Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM. Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals. Hypertension. 2006;47(3):345–51.

    Article  CAS  PubMed  Google Scholar 

  58. Turner BJ, Hollenbeak CS, Weiner M, Ten Have T, Tang SS. Effect of unrelated comorbid conditions on hypertension management. Ann Intern Med. 2008;148(8):578–86.

    Article  PubMed  Google Scholar 

  59. Rose AJ, Berlowitz DR, Orner MB, Kressin NR. Understanding uncontrolled hypertension: is it the patient or the provider? J Clin Hypertens. 2007;9(12):937–43.

    Article  Google Scholar 

  60. Berlowitz DR, Ash AS, Hickey EC, Friedman RH, Glickman M, Kader B, et al. Inadequate management of blood pressure in a hypertensive population. N Engl J Med. 1998;339(27):1957–63.

    Article  CAS  PubMed  Google Scholar 

  61. Aziz H, Hatah E, Makmor Bakry M, Islahudin F. How payment scheme affects patients' adherence to medications? A systematic review. Patient Prefer Adherence. 2016;10:837–50.

    PubMed  PubMed Central  Google Scholar 

  62. Schoen C, Osborn R, Doty MM, Squires D, Peugh J, Applebaum S. A survey of primary care physicians in eleven countries, 2009: perspectives on care, costs, and experiences. Health Aff. 2009;28(6):w1171–83.

    Article  Google Scholar 

  63. Morrison V, Fragher E, Parveen S, Plumpton C, Cylne W, De Geest S, et al. Determinants of patient adherence to antihypertensive medication: a multi-national cross-sectional survey. 2012: 78–103 pp.

    Google Scholar 

  64. Schafheutle EI, Hassell K, Noyce PR, Weiss MC. Access to medicines: cost as an influence on the views and behaviour of patients. Health Soc Care Community. 2002;10(3):187–95.

    Article  PubMed  Google Scholar 

  65. Croog SH, Levine S, Testa MA, Brown B, Bulpitt CJ, Jenkins CD, et al. The effects of antihypertensive therapy on the quality of life. N Engl J Med. 1986;314(26):1657–64.

    Article  CAS  PubMed  Google Scholar 

  66. Flack JM, Novikov SV, Ferrario CM. Benefits of adherence to anti-hypertensive drug therapy. Eur Heart J. 1996;17(Suppl A):16–20.

    Article  PubMed  Google Scholar 

  67. Dusing R, Weisser B, Mengden T, Vetter H. Changes in antihypertensive therapy—the role of adverse effects and compliance. Blood Press. 1998;7(5–6):313–5.

    PubMed  CAS  Google Scholar 

  68. Caro JJ, Speckman JL, Salas M, Raggio G, Jackson JD. Effect of initial drug choice on persistence with antihypertensive therapy: the importance of actual practice data. CMAJ. 1999;160(1):41–6.

    PubMed  PubMed Central  CAS  Google Scholar 

  69. Bloom BS. Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther. 1998;20(4):671–81.

    Article  CAS  PubMed  Google Scholar 

  70. Payne KA, Esmonde-White S. Observational studies of antihypertensive medication use and compliance: is drug choice a factor in treatment adherence? Curr Hypertens Rep. 2000;2(6):515–24.

    Article  CAS  PubMed  Google Scholar 

  71. Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet. 2000;355(9204):637–45.

    Article  CAS  PubMed  Google Scholar 

  72. Conlin PR, Gerth WC, Fox J, Roehm JB, Boccuzzi SJ. Four-Year persistence patterns among patients initiating therapy with the angiotensin II receptor antagonist losartan versus other artihypertensive drug classes. Clin Ther. 2001;23(12):1999–2010.

    Article  CAS  PubMed  Google Scholar 

  73. Neaton JD, Grimm RH Jr, Prineas RJ, Stamler J, Grandits GA, Elmer PJ, et al. Treatment of Mild Hypertension Study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA. 1993;270(6):713–24.

    Article  CAS  PubMed  Google Scholar 

  74. Philipp T, Anlauf M, Distler A, Holzgreve H, Michaelis J, Wellek S. Randomised, double blind, multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study. HANE Trial Research Group. BMJ. 1997;315(7101):154–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Vrijens B, Sotiris A, Burnier M, de la Sierra A, Volpe M. Current situation of medication adherence in hypertension. Fornt Pharmacol. 2017;8:100.

    Google Scholar 

  76. Fargher E, Plumpton C, Morrison V, Hughes D. Preferences for persistence with medications: results froma a mulit-national discrete choice experiment. 2012: 104–26 pp.

    Google Scholar 

  77. Ingersoll KS, Cohen J. The impact of medication regimen factors on adherence to chronic treatment: a review of literature. J Behav Med. 2008;31(3):213–24.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Dunbar-Jacob J, Bohachick P, Mortimer MK, Sereika SM, Foley SM. Medication adherence in persons with cardiovascular disease. J Cardiovasc Nurs. 2003;18(3):209–18.

    Article  PubMed  Google Scholar 

  79. Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med. 1990;150(9):1881–4.

    Article  CAS  PubMed  Google Scholar 

  80. Lee JY, Kusek JW, Greene PG, Bernhard S, Norris K, Smith D, et al. Assessing medication adherence by pill count and electronic monitoring in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study. Am J Hypertens. 1996;9(8):719–25.

    Article  CAS  PubMed  Google Scholar 

  81. Yiannakopoulou E, Papadopulos JS, Cokkinos DV, Mountokalakis TD. Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil. 2005;12(3):243–9.

    Article  PubMed  Google Scholar 

  82. Iskedjian M, Einarson TR, MacKeigan LD, Shear N, Addis A, Mittmann N, et al. Relationship between daily dose frequency and adherence to antihypertensive pharmacotherapy: evidence from a meta-analysis. Clin Ther. 2002;24(2):302–16.

    Article  PubMed  Google Scholar 

  83. Chapman RH, Benner JS, Petrilla AA, Tierce JC, Collins SR, Battleman DS, et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med. 2005;165(10):1147–52.

    Article  PubMed  Google Scholar 

  84. George J, Shalansky SJ. Predictors of refill non-adherence in patients with heart failure. Br J Clin Pharmacol. 2007;63(4):488–93.

    Article  PubMed  Google Scholar 

  85. Burnier M, Brown RE, Ong SH, Keskinaslan A, Khan ZM. Issues in blood pressure control and the potential role of single-pill combination therapies. Int J Clin Pract. 2009;63(5):790–8.

    Article  CAS  PubMed  Google Scholar 

  86. Pan F, Chernew ME, Fendrick AM. Impact of fixed-dose combination drugs on adherence to prescription medications. J Gen Intern Med. 2008;23(5):611–4.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Gerbino PP, Shoheiber O. Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents. Am J Health Syst Pharm. 2007;64(12):1279–83.

    Article  CAS  PubMed  Google Scholar 

  88. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010;55(2):399–407.

    Article  CAS  PubMed  Google Scholar 

  89. Sherrill B, Halpern M, Khan S, Zhang J, Panjabi S. Single-pill vs free-equivalent combination therapies for hypertension: a meta-analysis of health care costs and adherence. J Clin Hypertens. 2011;13(12):898–909.

    Article  Google Scholar 

  90. Comte L, Vrijens B, Tousset E, Gerard P, Urquhart J. Estimation of the comparative therapeutic superiority of QD and BID dosing regimens, based on integrated analysis of dosing history data and pharmacokinetics. J Pharmacokinet Pharmacodyn. 2007;34(4):549–58.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

    Valentina Forni Ogna & Michel Burnier

Authors
  1. Valentina Forni Ogna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michel Burnier
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Valentina Forni Ogna .

Editor information

Editors and Affiliations

  1. Service of Nephrology and Hypertension, CHUV, University of Lausanne, Lausanne, Vaud, Switzerland

    Michel Burnier

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ogna, V.F., Burnier, M. (2018). Determinants and Barriers to Adherence in Hypertension. In: Burnier, M. (eds) Drug Adherence in Hypertension and Cardiovascular Protection. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-76593-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-76593-8_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-76592-1

  • Online ISBN: 978-3-319-76593-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation