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May 24, 1976

Management of Hypertension: The Problem of Physician Adherence

Author Affiliations

White Plains, NY; Indianapolis
From the National High Blood Pressure Education Program, National Heart and Lung Institute and the New York Medical College, Valhalla (Dr Moser), and the Indiana University School of Medicine, Indianapolis (Dr Wood).

JAMA. 1976;235(21):2297-2298. doi:10.1001/jama.1976.03260470015017

ARTICLES have recently appeared suggesting ways to improve physician compliance or adherence in the management of hypertension, a disease that requires continuous, long-term treatment and that most frequently is asymptomatic.1-3 Patients with hypertension, unlike those with bursitis, high fever, or prominent symptoms, do not usually seek medical care and may be reluctant to accept care when it is suggested. Various methods have been used and advocated to increase patient adherence to a treatment program: the pill count, home blood pressures, drug detection tests, visiting nurse services, follow-up notices, and others. Some of these have been effective; often they are impractical. Too little attention is still being paid to the role of the physician in terms of his adherence to the management of hypertension.

Several statistics stand out in a recent report from the National Heart and Lung Institute. Specifically, a definite increase has occurred in the number of patients