Patients’ perspectives on the management of hypertension in seven European countries: Insights from a survey of 4000 treated patients

INTRODUCTION: Few studies have assessed the patients' perception of the management of their hypertension in Europe. OBJECTIVES: We compared the attitudes, barriers and expectations of patients receiving treatment for hypertension in 7 European countries. PATIENTS AND METHODS: Cross-sectional data were obtained between January and April 2023, using a web-based questionnaire translated into each country's official language and distributed in Czech Republic, France, Germany, Italy, Poland, Spain and United Kingdome (UK). 4001 treated hypertensive adults returned a valid questionnaire: mean age was 68.3 (9.2) years (median 70 y); 59.7% were males and 91% were treated for >1 year. RESULTS: Participants from Poland and Czech Republic had a higher cardiovascular risk profile compared to other countries (P<0.001). Differences across countries were found for lifestyle, medical and emotional risk scores (P <0.001). The median total number of pills/day was 4.0 (range: 3 to 5/day; P <0.001 between countries) and 2.0 for antihypertensive drugs. The frequency of follow-up visits/year was highest in France and lowest in the UK (P <0.001). In all countries, 10-20% of participants expressed the need for more information mainly on treatment, drugs side effects and hypertension complications. Non-intentional interruption of medications was the main cause of nonadherence. CONCLUSIONS: The management of hypertension is highly variable among European countries according to patients. Our survey identifies features that could be improved such as increasing the information/knowledge provided to patients, empowering patients through adequate home blood pressure monitoring and supporting medication adherence.