Urban-Rural Difference in Treatment Adherence of Chinese Hypertensive Patients

Objective: The aims of this study were to evaluate the treatment adherence and the main factors associated with adherence for Chinese hypertensive patients between urban and rural areas. Participants and Methods: A total of 529 hypertensive patients with 328 from urban areas and 201 from rural areas hospitalized in a tertiary hospital in Xi'an, China during the period from May 1 to December 31, 2021 were invited to participate in the cross-sectional study. The adherence to treatment was assessed by "modified Chinese Hill-Bone compliance to high blood pressure therapy scale". Binary logistic regression analysis was used to analyze independent risk factor for treatment adherence of hypertensive patients. General linear model was used to analyze the association of the independent risk factors to treatment adherence in each subgroup of the scale. Results: The treatment adherence of Chinese hypertensive patients in rural areas was 23.88% and it was significantly lower than that in urban areas (36.59%). Age and gender were the factors that independently associated with treatment adherence of hypertensive patients regardless of urban or rural status. The duration of antihypertensive drugs used was identified to be the factor that independently associated with treatment adherence only in urban patients. The subgroups including reduced sodium intake and medication taking had significant effects on treatment adherence in certain factors. Conclusion: The treatment adherence of Chinese hypertensive patients was low, especially in rural areas. More emphasis should be placed on patients in rural areas. Furthermore, more attention and effective strategies should be designed to address factors affecting treatment adherence in both urban and rural areas. Health programs should focus on education including the importance of taking continuous antihypertensive drugs and low sodium diet.