Q: I know of two instances in which people on blood-pressure medication abruptly stopped taking their medication and had strokes. Don't people know better?
A: Medication adherence or compliance is a big issue, not just with blood pressure medications. One consumer group estimates that 125,000 people die a year in the United States because they do not take medications as prescribed.
Noncompliance, according to the National Consumers League, can include:
- not filling a new prescription or not refilling an existing one when you are supposed to;
- stopping a medicine before the instructions say you should;
- taking more or less of the prescribed medicine;
- taking the medicine at the wrong time.
The consumer group in March launched a three-year campaign to educate people about the importance of taking medication as prescribed. The campaign will target people with diabetes, cardiovascular disease and respiratory conditions.
Hypertension is sometimes described as a silent killer because people can have it and not show symptoms.
Pharmacist Leonard Edloe said it would be unusual for someone who stopped taking blood-pressure medication one day to have a stroke as a result the next day.
"If something happened that way, they were already in the setup for a stroke," Edloe said. "Most people don't control their blood pressure. They are taking the medicine, but it's not under control."
A study from researchers at the University of Alabama at Birmingham looked at medication compliance and incidence of stroke symptoms. For the study, published in July, researchers analyzed data collected on 9,950 people taking blood-pressure medications. People were contacted every six months and asked about six stroke symptoms (sudden weakness on one side of the body, numbness, painless loss of vision in one or both eyes, loss of half vision, losing the ability to understand people and losing the ability to express oneself verbally or in writing).
People were rated on a score of 1 to 4 according to how compliant they were with taking their blood-pressure medication. The higher the score, the worse the adherence.
The study showed that people not taking their medication as prescribed were more likely to report experiencing stroke symptoms. There was also a dose-response effect — so that as the level of noncompliance rose, so did the percentage who reported stroke symptoms.
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