- Email: [email protected]
Quality of blood pressure measurement in the SPS3 (Secondary Prevention of Small Subcortical Strokes) study
AJH–May 2005–VOL. 18, NO. 5, PART 2
tan group(10.6% reduction)at the end of 8th week. The reduction in DBP was also signicantly greater in Telmisartan group (18.1% reduction) than in Losartan group (14.3% reduction)at end of 8th week. The laboratory values were within normal limits. Both drugs were well tolerated. Conclusion: Telmisartan 40 mg has equivalent safety but better efficacy than Losartan 50 mg in patients with mild to moderate hypertension. Key Words: Hypertension, Losartan, Telmisartan
P-225 OLMEBEST-STUDY: REDUCTION OF BLOOD PRESSURE IN THE TREATMENT OF PATIENTS WITH MILD-TO-MODERATE ESSENTIAL HYPERTENSION-Interims analysis of the German sub study S. Ewald, G. Nickenig, M. Bo¨hm. Sankyo Pharma GmbH, Mu¨nchen, Germany; University of Homburg, Germany. Objective: Newer data from hypertension outcome trials highlight the necessity of a quick and effective reduction of blood pressure; Olmesartan has demonstrated that a profound reduction of blood pressure can be expected within the first 14 treatment days which should be verified by this study. Design: The OLMEBEST study, a multinational, multicentre, partly randomised, double blind study inves-tigated the efficacy of a stepped care approach to treatment with Olmesartan 20 mg in the first step. After 14 days Placebo run-in patients received open label 20 mg Olmesartan for 8 weeks. Responders, defined as patients, in whom a reduction of diastolic blood pressure (DBP) of ⱖ10 mmHg after 8 weeks of treatment could be achieved or whose DBP was ⬍90 mmHg, normalisers were defined as patients whose DBP was ⬍90 mmHg after 8 weeks. Normalisers were treated for another 4 weeks open label with 20 mg Olmesartan. Results: A total of 823 patients (410 [male]/413 [female]; ⭋ 55.9 years; ⭋ BMI 28.6 kg/m2; duration of hypertension: median 2.96 years) in 208 study sites entered the study. After 8 weeks treatment with Olmesartan, mean sitting BP decreased from 157.6/97.9 mmHg to 140.5/ 86.1 mmHg in the total population, after 12 weeks the blood pressure reached 135.6/82.1 mmHg for the normalisers. Mean reduction from baseline after 8 weeks treatment in sitting DBP was 11.8 mmHg (normalisers: 14.8 mmHg; non-normalisers: 4.5 mmHg) and SBP was 17.1 mmHg (normalisers: 19.8 mmHg; non-normalisers: 10.7 mmHg). In normalisers continuing open-label Olmesartan treatment, mean reduction from baseline at 12 weeks in sitting DBP was 14.9 mmHg and in sitting SBP was 20.1 mmHg. The majority of blood pressure reduction was achieved within the first 14 days (SBP/ DBP total population 68.1%/ 66.8%; normalisers 63.3%/60.2%). The normalisation rate after 8 weeks treatment with 20 mg Olmesartan was 69.7% and response rate was impressive: 76.0% (week 8) respectively. Olmesartan once daily was well tolerated. 30.9% of the patients had at least one adverse event, 439 adverse events occurred during the study overall, of which 84.3% were not related (67.7% unrelated and 16.6% un-likely). Conclusions: Olmesartan once daily confirmed the early onset of the antihypertensive efficacy of Olmesartan, with the majority of the BPlowering effect having occurred within the first 2 weeks of treatment. It showed a profound efficacy in reducing elevated blood pressure with a normalisation rate of 69.7% after 8 weeks of treatment. The rapid onset of efficacy may partly explain the excellent responder rates, observed in this study. Key Words: blood pressure reduction, clinical trial, Olmesartan
POSTERS: Clinical Trials
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P-226 MP-27 EFFICACY OF ACE INHIBITOR/CCB VS. ACE INHIBITOR/DIURETIC FIXED COMBINATION THERAPY FOR THE TREATMENT OF ESSENTIAL HYPERTENSION L. Gilderman, M. Weinberger, T. Salko, M. Khan, V. Shi. University Clinical Research, Pembroke Pines, FL; Indiana University School of Medicine, Indianapolis, IN; Novartis Pharmaceuticals Corporation, East Hanover, NJ. The majority of patients with hypertension will require therapy with 2 or more agents to achieve goal blood pressure. The Seventh Report of the Joint National Commission (JNC 7) recommends combination therapy for all patients that are at least 20/10 mmHg above goal. The purpose of these double blind studies was to demonstrate the superiority, efficacy and safety of the combination of an amlodipine besylate, a long acting dihydropyridine CCB and benazepril, an ACEI compared to lisinopril (ACEI) and the diuretic hydrochlorothiazide. Following a 2–week washout period and one week placebo lead in, patients were randomly assigned to one of 4 treatment arms between the two studies: (1) amlodipine besylate 5 mg/benazepril 20 mg, for 4 weeks, then force titrated to amlodipine besylate 10 mg /benazepril 40 mg for an additional 8 weeks, vs., (2) lisinopril 10 mg/hydrochlorothiazide 12.5 and lisinopril 20 mg/hydrochlorothiazide 25 mg or (3) amlodipine besylate 10 mg/ benazepril 40 mg vs. (4) lisinopril 20 mg/hydrochlorothiazide 25 mg for 12 weeks. 1042 patients were randomized between the two studies, with 901 completing 12 weeks of treatment. The mean age was 52.3 and 51.9 years, respectively with a mean sitting baseline BP of 152/103 and 153/104 in each study. Responders were those who achieved a mean sitting diastolic blood pressure (MSDBP) of ⬍90 mmHg or a ⱖ10 mmHg decrease in MSDBP at treatment endpoint compared to baseline. In the amlodipine besylate/benazepril groups in each study 92.6 and 95.3 percent of patients achieved a response compared to a 91.0 and 91.8 percent of patients in the lisinopril/hydrochlorothiazide groups. In regards to safety, the overall incidence of adverse events was comparable between treatment groups across both studies. There were a total of 18 patients in both studies, 9 in each treatment group, who experienced serious adverse events. All serious adverse events were not related to study drug, with the exception of one patient in the lisinopril/hydrochlorothiazide group who developed angioedema leading to discontinuation of study medication. A male patient in the amlodipine besylate/benazepril group died as the result of gastrointestinal hemorrhage. However, study drug was not the suspected cause. From this data it can be concluded that amlodipine besylate/benazepril and lisinopril/hydrochlorothiazide are well tolerated, safe treatment options to reduce diastolic BP in hypertensive patients. Key Words: Amlodipine, Benazepril, Hypertension
P-227 QUALITY OF BLOOD PRESSURE MEASUREMENT IN THE SPS3 (SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES) STUDY John W. Graves, Chris S. Coffey. Division of Hypertension and Nephrology, Mayo Clinic College of Medicine, Rochester, MN; Department of Biostatistics, University of Alabama Birmingham, Birmingham, AL. The SPS3 study is an ongoing NIH trial evaluating intensity of BP treatment and antiplatelet treatment in prevention of 2nd stroke in patients with lacunar infarct. As such, accurate BP measurement and recording is critical to successful coutcome of the trial. This study looks for skip digits by the automated BP device (Collins Pressmate) and for digit prejudice by the observers. All SBP and DBP recorded in the trial as of 10/11/04 were analyzed for evidence of skipped digits (algorithm failure). The average reported BP value from the most recent active quarterly visit using the automated
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device was analyzed for evidence of digit prejudice. Within each target treatment group, the distribution of SBP and DBP was tabulated and a kernel density estimator was used to overlay a log-normal distribution. These tabulations were then visually examined to determine if there is a suggestion of digit prejudice near the target levels for the two groups. Our study had 372 pts. with 8735 blood pressure measurements for analysis (Baseline N⫽3061, Medication titration N⫽1944, Quarterly visits N⫽3730). No evidence of skipped digit for SBP in the range of 82-230 mm Hg nor for DBP in range of 40-120 mm Hg was found. 272 pts. had at least one quarterly visit while on active antiplatelet therapy (SBP⬍ 130 mm HG N⫽135, SBP 130-149 mm Hg N⫽137) where digit prejudice could be analyzed. For SBP⬍ 130 mm Hg no digit prejudice was found. For SBP130-149 mm Hg there is a suggestion of abnormal distribution of SBP 130-134 (Figure 1) with a smaller abnormal peak at 144-150 mm Hg. realized at 400 mg is attained with the 200 mg dose. Adverse effects such as fatigue are largely restricted to the highest Toprol XL- doses. Key Words: Beta Blocker, Clinical Trial, Dose Response
P-229 NATIONAL STUDY ON COMPLIANCE TO TREATMENT
The Collins Pressmate algorithm does not have skipped digits as seen with DINAMAP. Clustering of SBP in the SBP 130-149 Mm Hg is worrisome for digit prejudice. Continued monitoring at 6 months intervals during the trial is needed to confirm this finding. Key Words: Automated Blood Pressure Measurement, Digit Prejeudcie, SPS3 (Secondary Prevention of Small Subcortical Strokes) Trial
P-228 METOPROLOL SUCCINATE EXTENDED RELEASE: ANTIHYPERTENSIVE DOSE RESPONSE CHARACTERISTICS James Hainer, Vasilios Papademetriou, William Frishman, Jennifer Sugg, Jonathan Sorof. Cardiovascular Clinical Research, AstraZeneca, Wilmington, DE; Medicine, Georgetown University, Washington, DC; Medicine and Pharmacology, New York Medical College/Westchester Medical Center, Valhalla, NY. Metoprolol succinate extended release (Toprol-XL) is a widely prescribed beta-blocking agent. Two large clinical trials evaluated the antihypertensive effect of Toprol - XL and included doses ranging from 25 mg to 400 mg once daily. Both were randomized, double-blind, placebocontrolled factorial studies of 8 or 9 weeks duration in patients with primary hypertension (DBP ⬎⫽ 95, ⬍⫽114; SBP ⬍200 (Trial 1) or ⬍180 (Trial 2). The primary efficacy measure was change from baseline in sitting DBP. Trial 1 (Total N⫽1087 ) evaluated doses of 25 mg, 100 mg and 400 mg. Trial 2 ( Total N⫽1559) evaluated. Toprol- XL doses of 25, 50 , 100 and 200 mg. Treatment groups were well balanced with regard to baseline characteristics. Mean baseline BP was 152/100. Decline in mean DBP and SBP was dose related. Change in DBP at all doses levels was superior to placebo (p⬍0.05). Adverse event study discontinuation rates: placebo ⫽5.7 % and Toprol- XL ⫽3.6% (Trial 1 ⫹ Trial 2). Fatigue occurred in 5.0% of patients at Toprol- XL doses ⬎⫽ 200, 3.7% at doses 25-100 mg and 1.2 % with placebo. Mean heart rate decline (beats / min) was also dose related: 3.9 for doses 25-100; 9.7 for doses ⬎⫽ 200 mg; 0.5 for placebo. Toprol XL lowers blood pressure over the range of doses, 25mg to 400 mg once daily. Most of the reduction
Roberto A Ingaramo, Ne´stor A Vita, Mario Bendersky, Miguel Arnolt, Claudio Bellido, Daniel Piskorz, Omar Lindstrom, Emilio Marigliano, Angel F Garcı´a Piazza, Rafael Manzur, Sergio Hauad, Alfredo Donatto, Mirta Santana. Hypertension Committee, Argentine Federation of Cardiology, Trelew, Chubut, Argentina. The noncompliance to treatment is one of the main causes of the poor control of high blood pressure. Patient’s self-reports about adherence, such as the Morisky-Green-Levine test (MGLT), were proven to predict the blood pressure (BP) control. The objective of the study was, using the MGLT, to evaluate the compliance to treatment, and related to that, the control of BP in a group of essential hypertensive patients. Secondarily, we proposed to check the antihypertensive drugs used. We included a total of 1784 patientes (P) under treatment for no less than six months, 999 women, mean age 46 years. The patients filled out a questionnaire that included epidemiological data and the four questions of the MGLT, after which their BP was taken. 859 patients (48,15%) were compliant while 925 (51,85%) were noncompliant. Although the difference was not significant, the noncompliant group showed a greater lack of control in the systo-diastolic BP (SDBP), 60% vs. 56% in the compliant group (p ⫽ .084) However, isolated systolic (ISBP) and diastolic BP (IDBP) showed a higher degree of control in the compliant group (55% vs. 49%, p ⫽ .032 and 34% vs. 28%, p ⫽ .086) There were no differences between the groups in the mean values of the systolic (p ⫽ .567) and diastolic BP (p ⫽ .088), or the age (p ⫽ .799), body mass index (p ⫽ .326) and time of treatment (p ⫽ .215) Analizing the four questions separately, the diastolic BP was greater in those that failed to answer the questions (p ⬍ .05) Men compliant to treatment showed greater control in the SDBP, ISBP and IDBP in comparaison to those in the noncompliant group ( p ⫽ .008, .0032 and .017), but the same was not true in women (p ⫽ .819, .669 and .634) The percentage of patients with health care insurance were less noncompliant than those without health care insurance, 27% vs. 33% (p ⫽ .026) The drugs most frequently used were angiotensin-converting enzyme inhibitors, 30.31%, followed by beta blockers, 22.34%. The ratio of compliance after 6 months of treatment did not surpass 50%. The MGLT showed itself useful in determining the adherence to treatment, and those who failed to answer will have a lesser degree of high blood pressure control and greater possibilities of having an elevated diastolic blood pressure Key Words: Adherence to Treatment, Blood Pressure Control, MoriskyGreen-Levine Test
tan group(10.6% reduction)at the end of 8th week. The reduction in DBP was also signicantly greater in Telmisartan group (18.1% reduction) than in Losartan group (14.3% reduction)at end of 8th week. The laboratory values were within normal limits. Both drugs were well tolerated. Conclusion: Telmisartan 40 mg has equivalent safety but better efficacy than Losartan 50 mg in patients with mild to moderate hypertension. Key Words: Hypertension, Losartan, Telmisartan
P-225 OLMEBEST-STUDY: REDUCTION OF BLOOD PRESSURE IN THE TREATMENT OF PATIENTS WITH MILD-TO-MODERATE ESSENTIAL HYPERTENSION-Interims analysis of the German sub study S. Ewald, G. Nickenig, M. Bo¨hm. Sankyo Pharma GmbH, Mu¨nchen, Germany; University of Homburg, Germany. Objective: Newer data from hypertension outcome trials highlight the necessity of a quick and effective reduction of blood pressure; Olmesartan has demonstrated that a profound reduction of blood pressure can be expected within the first 14 treatment days which should be verified by this study. Design: The OLMEBEST study, a multinational, multicentre, partly randomised, double blind study inves-tigated the efficacy of a stepped care approach to treatment with Olmesartan 20 mg in the first step. After 14 days Placebo run-in patients received open label 20 mg Olmesartan for 8 weeks. Responders, defined as patients, in whom a reduction of diastolic blood pressure (DBP) of ⱖ10 mmHg after 8 weeks of treatment could be achieved or whose DBP was ⬍90 mmHg, normalisers were defined as patients whose DBP was ⬍90 mmHg after 8 weeks. Normalisers were treated for another 4 weeks open label with 20 mg Olmesartan. Results: A total of 823 patients (410 [male]/413 [female]; ⭋ 55.9 years; ⭋ BMI 28.6 kg/m2; duration of hypertension: median 2.96 years) in 208 study sites entered the study. After 8 weeks treatment with Olmesartan, mean sitting BP decreased from 157.6/97.9 mmHg to 140.5/ 86.1 mmHg in the total population, after 12 weeks the blood pressure reached 135.6/82.1 mmHg for the normalisers. Mean reduction from baseline after 8 weeks treatment in sitting DBP was 11.8 mmHg (normalisers: 14.8 mmHg; non-normalisers: 4.5 mmHg) and SBP was 17.1 mmHg (normalisers: 19.8 mmHg; non-normalisers: 10.7 mmHg). In normalisers continuing open-label Olmesartan treatment, mean reduction from baseline at 12 weeks in sitting DBP was 14.9 mmHg and in sitting SBP was 20.1 mmHg. The majority of blood pressure reduction was achieved within the first 14 days (SBP/ DBP total population 68.1%/ 66.8%; normalisers 63.3%/60.2%). The normalisation rate after 8 weeks treatment with 20 mg Olmesartan was 69.7% and response rate was impressive: 76.0% (week 8) respectively. Olmesartan once daily was well tolerated. 30.9% of the patients had at least one adverse event, 439 adverse events occurred during the study overall, of which 84.3% were not related (67.7% unrelated and 16.6% un-likely). Conclusions: Olmesartan once daily confirmed the early onset of the antihypertensive efficacy of Olmesartan, with the majority of the BPlowering effect having occurred within the first 2 weeks of treatment. It showed a profound efficacy in reducing elevated blood pressure with a normalisation rate of 69.7% after 8 weeks of treatment. The rapid onset of efficacy may partly explain the excellent responder rates, observed in this study. Key Words: blood pressure reduction, clinical trial, Olmesartan
POSTERS: Clinical Trials
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P-226 MP-27 EFFICACY OF ACE INHIBITOR/CCB VS. ACE INHIBITOR/DIURETIC FIXED COMBINATION THERAPY FOR THE TREATMENT OF ESSENTIAL HYPERTENSION L. Gilderman, M. Weinberger, T. Salko, M. Khan, V. Shi. University Clinical Research, Pembroke Pines, FL; Indiana University School of Medicine, Indianapolis, IN; Novartis Pharmaceuticals Corporation, East Hanover, NJ. The majority of patients with hypertension will require therapy with 2 or more agents to achieve goal blood pressure. The Seventh Report of the Joint National Commission (JNC 7) recommends combination therapy for all patients that are at least 20/10 mmHg above goal. The purpose of these double blind studies was to demonstrate the superiority, efficacy and safety of the combination of an amlodipine besylate, a long acting dihydropyridine CCB and benazepril, an ACEI compared to lisinopril (ACEI) and the diuretic hydrochlorothiazide. Following a 2–week washout period and one week placebo lead in, patients were randomly assigned to one of 4 treatment arms between the two studies: (1) amlodipine besylate 5 mg/benazepril 20 mg, for 4 weeks, then force titrated to amlodipine besylate 10 mg /benazepril 40 mg for an additional 8 weeks, vs., (2) lisinopril 10 mg/hydrochlorothiazide 12.5 and lisinopril 20 mg/hydrochlorothiazide 25 mg or (3) amlodipine besylate 10 mg/ benazepril 40 mg vs. (4) lisinopril 20 mg/hydrochlorothiazide 25 mg for 12 weeks. 1042 patients were randomized between the two studies, with 901 completing 12 weeks of treatment. The mean age was 52.3 and 51.9 years, respectively with a mean sitting baseline BP of 152/103 and 153/104 in each study. Responders were those who achieved a mean sitting diastolic blood pressure (MSDBP) of ⬍90 mmHg or a ⱖ10 mmHg decrease in MSDBP at treatment endpoint compared to baseline. In the amlodipine besylate/benazepril groups in each study 92.6 and 95.3 percent of patients achieved a response compared to a 91.0 and 91.8 percent of patients in the lisinopril/hydrochlorothiazide groups. In regards to safety, the overall incidence of adverse events was comparable between treatment groups across both studies. There were a total of 18 patients in both studies, 9 in each treatment group, who experienced serious adverse events. All serious adverse events were not related to study drug, with the exception of one patient in the lisinopril/hydrochlorothiazide group who developed angioedema leading to discontinuation of study medication. A male patient in the amlodipine besylate/benazepril group died as the result of gastrointestinal hemorrhage. However, study drug was not the suspected cause. From this data it can be concluded that amlodipine besylate/benazepril and lisinopril/hydrochlorothiazide are well tolerated, safe treatment options to reduce diastolic BP in hypertensive patients. Key Words: Amlodipine, Benazepril, Hypertension
P-227 QUALITY OF BLOOD PRESSURE MEASUREMENT IN THE SPS3 (SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES) STUDY John W. Graves, Chris S. Coffey. Division of Hypertension and Nephrology, Mayo Clinic College of Medicine, Rochester, MN; Department of Biostatistics, University of Alabama Birmingham, Birmingham, AL. The SPS3 study is an ongoing NIH trial evaluating intensity of BP treatment and antiplatelet treatment in prevention of 2nd stroke in patients with lacunar infarct. As such, accurate BP measurement and recording is critical to successful coutcome of the trial. This study looks for skip digits by the automated BP device (Collins Pressmate) and for digit prejudice by the observers. All SBP and DBP recorded in the trial as of 10/11/04 were analyzed for evidence of skipped digits (algorithm failure). The average reported BP value from the most recent active quarterly visit using the automated
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device was analyzed for evidence of digit prejudice. Within each target treatment group, the distribution of SBP and DBP was tabulated and a kernel density estimator was used to overlay a log-normal distribution. These tabulations were then visually examined to determine if there is a suggestion of digit prejudice near the target levels for the two groups. Our study had 372 pts. with 8735 blood pressure measurements for analysis (Baseline N⫽3061, Medication titration N⫽1944, Quarterly visits N⫽3730). No evidence of skipped digit for SBP in the range of 82-230 mm Hg nor for DBP in range of 40-120 mm Hg was found. 272 pts. had at least one quarterly visit while on active antiplatelet therapy (SBP⬍ 130 mm HG N⫽135, SBP 130-149 mm Hg N⫽137) where digit prejudice could be analyzed. For SBP⬍ 130 mm Hg no digit prejudice was found. For SBP130-149 mm Hg there is a suggestion of abnormal distribution of SBP 130-134 (Figure 1) with a smaller abnormal peak at 144-150 mm Hg. realized at 400 mg is attained with the 200 mg dose. Adverse effects such as fatigue are largely restricted to the highest Toprol XL- doses. Key Words: Beta Blocker, Clinical Trial, Dose Response
P-229 NATIONAL STUDY ON COMPLIANCE TO TREATMENT
The Collins Pressmate algorithm does not have skipped digits as seen with DINAMAP. Clustering of SBP in the SBP 130-149 Mm Hg is worrisome for digit prejudice. Continued monitoring at 6 months intervals during the trial is needed to confirm this finding. Key Words: Automated Blood Pressure Measurement, Digit Prejeudcie, SPS3 (Secondary Prevention of Small Subcortical Strokes) Trial
P-228 METOPROLOL SUCCINATE EXTENDED RELEASE: ANTIHYPERTENSIVE DOSE RESPONSE CHARACTERISTICS James Hainer, Vasilios Papademetriou, William Frishman, Jennifer Sugg, Jonathan Sorof. Cardiovascular Clinical Research, AstraZeneca, Wilmington, DE; Medicine, Georgetown University, Washington, DC; Medicine and Pharmacology, New York Medical College/Westchester Medical Center, Valhalla, NY. Metoprolol succinate extended release (Toprol-XL) is a widely prescribed beta-blocking agent. Two large clinical trials evaluated the antihypertensive effect of Toprol - XL and included doses ranging from 25 mg to 400 mg once daily. Both were randomized, double-blind, placebocontrolled factorial studies of 8 or 9 weeks duration in patients with primary hypertension (DBP ⬎⫽ 95, ⬍⫽114; SBP ⬍200 (Trial 1) or ⬍180 (Trial 2). The primary efficacy measure was change from baseline in sitting DBP. Trial 1 (Total N⫽1087 ) evaluated doses of 25 mg, 100 mg and 400 mg. Trial 2 ( Total N⫽1559) evaluated. Toprol- XL doses of 25, 50 , 100 and 200 mg. Treatment groups were well balanced with regard to baseline characteristics. Mean baseline BP was 152/100. Decline in mean DBP and SBP was dose related. Change in DBP at all doses levels was superior to placebo (p⬍0.05). Adverse event study discontinuation rates: placebo ⫽5.7 % and Toprol- XL ⫽3.6% (Trial 1 ⫹ Trial 2). Fatigue occurred in 5.0% of patients at Toprol- XL doses ⬎⫽ 200, 3.7% at doses 25-100 mg and 1.2 % with placebo. Mean heart rate decline (beats / min) was also dose related: 3.9 for doses 25-100; 9.7 for doses ⬎⫽ 200 mg; 0.5 for placebo. Toprol XL lowers blood pressure over the range of doses, 25mg to 400 mg once daily. Most of the reduction
Roberto A Ingaramo, Ne´stor A Vita, Mario Bendersky, Miguel Arnolt, Claudio Bellido, Daniel Piskorz, Omar Lindstrom, Emilio Marigliano, Angel F Garcı´a Piazza, Rafael Manzur, Sergio Hauad, Alfredo Donatto, Mirta Santana. Hypertension Committee, Argentine Federation of Cardiology, Trelew, Chubut, Argentina. The noncompliance to treatment is one of the main causes of the poor control of high blood pressure. Patient’s self-reports about adherence, such as the Morisky-Green-Levine test (MGLT), were proven to predict the blood pressure (BP) control. The objective of the study was, using the MGLT, to evaluate the compliance to treatment, and related to that, the control of BP in a group of essential hypertensive patients. Secondarily, we proposed to check the antihypertensive drugs used. We included a total of 1784 patientes (P) under treatment for no less than six months, 999 women, mean age 46 years. The patients filled out a questionnaire that included epidemiological data and the four questions of the MGLT, after which their BP was taken. 859 patients (48,15%) were compliant while 925 (51,85%) were noncompliant. Although the difference was not significant, the noncompliant group showed a greater lack of control in the systo-diastolic BP (SDBP), 60% vs. 56% in the compliant group (p ⫽ .084) However, isolated systolic (ISBP) and diastolic BP (IDBP) showed a higher degree of control in the compliant group (55% vs. 49%, p ⫽ .032 and 34% vs. 28%, p ⫽ .086) There were no differences between the groups in the mean values of the systolic (p ⫽ .567) and diastolic BP (p ⫽ .088), or the age (p ⫽ .799), body mass index (p ⫽ .326) and time of treatment (p ⫽ .215) Analizing the four questions separately, the diastolic BP was greater in those that failed to answer the questions (p ⬍ .05) Men compliant to treatment showed greater control in the SDBP, ISBP and IDBP in comparaison to those in the noncompliant group ( p ⫽ .008, .0032 and .017), but the same was not true in women (p ⫽ .819, .669 and .634) The percentage of patients with health care insurance were less noncompliant than those without health care insurance, 27% vs. 33% (p ⫽ .026) The drugs most frequently used were angiotensin-converting enzyme inhibitors, 30.31%, followed by beta blockers, 22.34%. The ratio of compliance after 6 months of treatment did not surpass 50%. The MGLT showed itself useful in determining the adherence to treatment, and those who failed to answer will have a lesser degree of high blood pressure control and greater possibilities of having an elevated diastolic blood pressure Key Words: Adherence to Treatment, Blood Pressure Control, MoriskyGreen-Levine Test