Compliance in hypertension: facts and concepts.

The management of hypertension is still far from optimal, although safe and effective drugs are available and the effectiveness of antihypertensive therapy in reducing cardiovascular morbidity is well established. Today, low patient compliance is one of the most important therapy-limiting factors in hypertension. Although patient care seems to have improved, possibly due to increased knowledge about patient compliance in recent years, 10-15% of hypertensives are still lost from follow-up in the first year of therapy, and 20-40% of patients comply insufficiently with prescribed antihypertensive therapy. In this article the magnitude of the problem of drop-outs and non-compliance with medication, the determinants of compliance in hypertension, and the models used to understand patients' health behaviour are reviewed.