In most cases, failing to take prescribed blood pressure medications -- what doctors call poor compliance -- does not explain why patients still have higher than normal blood pressure.

Past research found that only a minority of patients with high blood pressure consistently took their medications as prescribed, but no study has compared compliance in patients whose blood pressure was well-controlled with that in patients with poor blood pressure control.

The investigators, therefore, did exactly that -- measured blood pressure and monitored the medication taken by 105 patients, including 55 with good blood pressure control and 50 without.

Both groups of patients showed similar compliance with their prescriptions. More than 80% of each group took their medications regularly.

Did simply monitoring their behavior contribute to blood pressure control?

No, the authors show, as blood pressures did not change significantly in either group over the 4-week study.

Looking for other explanations, the researchers were able to show only that the more pills a person had to take, the less likely it was that he or she would take them consistently.

More than 90% of patients who had once-daily medication prescribed took their medication, whereas only 77% took their twice-daily medication.

Doctors very often believe that the lack of a response to their therapy is due to the fact that their patients do not follow their prescriptions correctly and do not take the drugs.

This may sometimes be the case but it is much less frequent than is commonly assumed and does not often explain resistance to therapy.

The investigators warned patients that the lack of a response to therapy might make the doctor believe that the patient does not take the drug.

British Medical Journal July 21, 2001;323:142-146

Dr. Mercola's Comments:

This is an important study as the investigators found that for most of the patients the medications were not important in controlling their blood pressure. So their question was: Why was blood pressure not controlled in nearly half the patients? They did could not provide an answer, but they found out enough to warn patients that they should expect their doctor of accusing them of non-compliance if their blood pressure was not controlled. So what is the reason that the blood pressure is not controlled? Well, if you have been reading this newsletter for any length of time you will know that insulin levels play a large role here. Sugars and grains that break down to sugar, such as bread, pasta, rice, potatoes, beans, cookies, cakes, cereals, oatmeal, toast and rice will all raise insulin levels in most people. Raised insulin levels will cause the blood pressure to go up in most people. For more details please review the food choice program. However, it is very important to note that insulin is not the only reason why blood pressure is raised. Emotional stresses also play an important role. It is also important to realize that uncontrolled high blood pressure can kill you by causing a stroke. So it is important to not stop any blood pressure medication unless you are professionally supervised. But strokes rarely occur if the systolic (upper number) blood pressure is below 170. The diastolic (lower number) is not as important for developing strokes. It is more important for long term problems. Related Articles: Placebo Lowers Blood Pressure in Nearly One-Third of Patients Even Dropping a Few Pounds Good for Blood Pressure Blood Pressure Treatment Usually Fails Losing Hostility Reduces Blood Pressure