ACHIEVEMENT OF BLOOD PRESSURE TARGET WITH MEDICATION ADHERENCE AND SODIUM CONSUMPTION IN SAIFUL ANWAR GENERAL HOSPITAL OUTPATIENT CLINIC

Abstract

Hypertension is a common clinical problem
that responsible of deaths account for 9.4 million
people in worldwide every year.1 The worldwide
prevalence of hypertension estimated increase from
26.4% in 2000 to 29.2% in 2025.2 An estimated 65
million adult Americans, or nearly one fourth of the
adult population of the United States, have
hypertension. Another quarter of the population
have prehypertension.3 RISKESDAS results shows
that the prevalence of hypertension in Indonesia was
26,5%.4
Among hypertensive patients in USA 11%
were not on treatment regimen, 25% were not on
adequate treatment, 34% were on adequate
treatment.3 In Indonesia, among hypertensive
patients only 9,5% were on treatment.4 In a recent
analysis of National Health and Nutrition
Examination Survey (NHANES) participants that 35,8
million (53,5%) were not reach blood pressure
target. Among these, an estimated 16.0 million
(44.8%) were aware of their hypertension and were
being treated with medication.5 In a cross-sectional
analysis of Framingham Heart Study participants,
only 48% of treated participants were controlled to
<140/90 mm Hg and less than 40% of elderly
participants (>75 years of age) were at a goal blood
pressure.6 These data suggested that hypertension
remained largely uncontrolled worlwide.
Uncontrolled hypertensive confer an increased of
cardiovascular events. Nearly one fourth of adults
with uncontrolled hypertension have stage 2
hypertension (systolic BP ≥160 mmHg or a diastolic
BP ≥100 mmHg), putting them at higher risk for
heart disease or stroke.5 According to the World
Health Report uncontrolled hypertension causes
over 7 million premature deaths, takes up 4.5% of
the total global disease burden, and accounts for
some 64 million disability adjusted life years lost.7
Randomized controlled trials have
convincingly shown that treatment of hypertension
reduces the risk of stroke, coronary heart disease,
congestive heart failure, and mortality.8 However it
was not easy to achieve blood pressure target. It
required an act of antihypertensive medication
therapy. The success of a therapy was not only
determined by the diagnosis and appropriate drug
selection, but also to carry out the patient's therapy
compliance, included compliance in taking
medication but in fact, adherent of medication was
poor.9 Moreover, non pharmacology theraphy that
treated hypertension is dietary of sodium. Reducing
dietary sodium additives may decrease hypertension
prevalence by 30%, resulting in one million fewer
hypertensive patients.10 It remains lacking data
regarding controlled hypertension in Indonesia up to
now. Therefore this research aimed to to investigate
medication adherence and sodium consumption to
achieve blood pressure target.