Résumé
BACKGROUND: With proper management, hypertensive patients can maintain their health and prevent complications. But poor compliance is a main problem for management of hypertension. This study was designed to investigate the reasons among hypertensive patients who did not initiate antihypertensive medication despite recommendations. METHODS: Questionnaires were used for hypertensive patients who visited a health care center and an outpatient clinic of family medicine department in a university hospital, from March to July, 1998. The non-medicated(noncompliant)group were those who had not taken antihypertensive drug at all with high blood pressure(higher than 160mmHg at systolic, or 100mmHg at diastolic phase initially and hypertensive range on the follow up), despite doctor's recommendations. The medicated(compliant) group were those hypertensive patients who had taken antihypertensive drug well and visited the clinic regularly at least for 9 months during the recent 12 months. RESULTS: The total number of the noncompliant was 65, and the compliant 57. The mean age of the noncompliant was 50.8, and the compliant 58.0 years old. The mean blood pressure in the noncompliant was 162.6/106.6mmHg, higher than in the compliant 138.1/85.7mmHg. The main reasons refusing antihypertensive drug were fearful feeling for `lifelong medication'(47.7%), followed by complications from drugs(30.8%). The reason for delaying treatment with antihypertensive drug is that the noncompliant showed more tendency to think `It would be the same', or `better than starting medication early' than the compliant. For the complications from drugs, 59.5% of the noncompliant answered. `I'm not sure, but it'll be not good', and those who answered `it'll be not bad to have medication' seemed to be less than in the noncompliant. CONCLUSION: The patients who had been recommended but did not start on medication had less knowledge about the benefits of medication. We can assume that they are refusing antihyper-tensives because of their excessive anxiety about complications of and lifelong medication.