Medication Adherence and Lifestyle Changes Among Treated Patients with Arterial Hypertension in Family Medicine in Croatia According to the EUROASPIRE V Study: A Cross-Sectional Study

Q: What are the key findings of this study?

Among treated patients with arterial hypertension in primary care, 56.9% reported 100% medication adherence, while 55.1% had suboptimal blood pressure control.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Arterial hypertension (n=156). Intervention: Antihypertensive medication and lifestyle recommendations. Primary outcome: Self-reported medication adherence to antihypertensive medication of 100% (all of the time).

Q: What does this research mean for the field?

A significant proportion of treated patients with arterial hypertension in Croatia exhibit suboptimal blood pressure control and suboptimal adherence to prescribed medications and lifestyle recommendations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Renata Romic; Venija Cerovečki; Ino Kermc; Zlata Ožvačić Adžić; Goranka Petriček; Miroslav Hanževački; Nataša Buljan; Pero Hrabač; Jure Samardžić; Zeljko Reiner; Davor Milicic

doi:10.3390/jcm15145376

July 9, 2026Journal of Clinical MedicineOpen Access

Medication Adherence and Lifestyle Changes Among Treated Patients with Arterial Hypertension in Family Medicine in Croatia According to the EUROASPIRE V Study: A Cross-Sectional Study

View Full Paper

Ask AI

Bookmark

Share

Key result

Only ~57% of primary care hypertension patients report full adherence, with over half remaining uncontrolled.

n=156

Figures

Why the study?

Adherence to recommended treatment is essential for blood pressure regulation and complication prevention in arterial hypertension, motivating an evaluation of medication and lifestyle adherence in Croatia.

Key Points

To evaluate adherence to antihypertensive medication and lifestyle modifications among patients with arterial hypertension treated in family medicine practices.
A cross-sectional study was conducted across nine family medicine practices in Zagreb, Croatia, adhering to the EUROASPIRE V primary care protocol.
Data were analyzed from 156 patients with arterial hypertension using the EUROASPIRE V questionnaire on self-assessed medication adherence and lifestyle modifications, including smoking, salt intake, and physical activity.
Target blood pressure control (<140/90 mmHg) was achieved in 44.9% (n = 70) of participants, while 55.1% had uncontrolled blood pressure despite 56.9% reporting 100% adherence to antihypertensive medication.
Reported adherence to lifestyle advice showed 74.4% reduced salt intake, 24.4% increased physical activity, 24.1% reduced smoking, and 13.8% quit smoking.
Multivariable logistic regression revealed that lower odds of adherence were significantly associated with higher HADS anxiety score (OR = 0.73, 95% CI 0.62–0.85, p < 0.001), current smoking (OR = 0.28, 95% CI 0.10–0.75, p = 0.012), self-employment (OR = 0.16, 95% CI 0.03–0.75, p = 0.020), and higher SCORE2 (OR = 0.85, 95% CI 0.76–0.95, p = 0.004), whereas older age was associated with higher odds (OR = 1.12, 95% CI 1.04–1.22, p = 0.005).

Study Design

Type

Cross-Sectional (n=156)

Multicenter

Yes

Structured PICO

P

Population

156 adults with arterial hypertension in primary care in Croatia, median age 65, 50.6% female, assessed for medication and lifestyle adherence.

E

Exposure

Assessment of adherence to antihypertensive medication and lifestyle recommendations (EUROASPIRE V questionnaire)

O

Outcome

Self-reported medication adherence (proportion reporting 100% adherence) and blood pressure control (<140/90 mmHg)patient reported

Despite high self-reported medication adherence, over half of treated hypertensive patients in primary care have suboptimal blood pressure control, highlighting the need for comprehensive lifestyle and pharmacological management.

Limitations

Adherence to medication and lifestyle data were assessed only by self-reporting, which may lead to a social desirability bias or recall bias
Generalizability is limited by selection bias, as only patients able to attend family medicine practices and willing to participate were included
Untreated individuals, those managed exclusively with lifestyle measures, or patients with limited access to healthcare were not represented

Implication

Self-reported adherence may not ensure BP control in primary care; leaves open contributions of lifestyle factors to real-world hypertension management.

Abstract

Introduction: Arterial hypertension (AH) is one of the leading public health issues worldwide, and patients’ adherence to recommended treatment is essential for successful regulation of blood pressure (BP), disease control, and prevention of complications. Aim: The aim of this study was to evaluate the adherence of patients with hypertension to medication and lifestyle changes in Croatia, based on the primary care arm of the EUROASPIRE V survey. Methods: A cross-sectional study was conducted in nine family medicine practices in the city of Zagreb, following the protocol of the EUROASPIRE V primary care study. Out of the total Croatian cohort of 203 participants, data on 156 participants with AH were included in this study. The study used components of the EUROASPIRE V questionnaire on self-assessment of adherence to medications, existing lifestyle characteristics and self-reported lifestyle changes (smoking, salt intake, and physical activity, respectively). Results: A total of 156 participants were included, with almost even distribution of men (n = 77, 49.4%) and women (n = 79, 50.6%); median age was 65 (57, 72). A self-reported medication adherence to antihypertensive medication of 100% (all of the time) was reported by 56.9% patients. According to the lifestyle change questionnaire, the highest adherence was concerning reduction in salt intake (74.4%), while smoking was reduced in 24.1% of advised participants with AH, 13.8% had quit smoking, and increased physical activity was reported by 24.4% patients. Conclusions: The results of the primary care arm of EUROASPIRE V study in Croatia on treated patients with AH indicate suboptimal BP control in a significant proportion of patients (55.1%) and suboptimal lifestyle change adherence. Achieving target BP and optimal disease control requires additional efforts to foster patients’ adherence to prescribed medications and lifestyle recommendations.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Romic et al. (2026) conducted a cross-sectional in Arterial hypertension (n=156). Antihypertensive medication and lifestyle recommendations was evaluated on Self-reported medication adherence to antihypertensive medication of 100% (all of the time). Among treated patients with arterial hypertension in primary care, 56.9% reported 100% medication adherence, while 55.1% had suboptimal blood pressure control.

synapsesocial.com/papers/6a51e168c18d7f28ca5011e8 https://doi.org/10.3390/jcm15145376

View Full Paper

Ask AI

Bookmark

Share

Medication Adherence and Lifestyle Changes Among Treated Patients with Arterial Hypertension in Family Medicine in Croatia According to the EUROASPIRE V Study: A Cross-Sectional Study

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Medication Adherence and Lifestyle Changes Among Treated Patients with Arterial Hypertension in Family Medicine in Croatia According to the EUROASPIRE V Study: A Cross-Sectional Study

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading