Blood Pressure Medication Side Effect Symptoms and Patient Treatment Satisfaction and Adherence

J Am Board Fam Med. 2025 Mar-Apr;38(2):312-329. doi: 10.3122/jabfm.2024.240288R1.

ABSTRACT

BACKGROUND: Side effect symptoms to blood pressure (BP) medications may be associated with medication nonadherence, treatment dissatisfaction, and worse BP control. This article describes the frequency and characteristics of BP medication side effect symptoms in a primary care population with poorly controlled hypertension and their relationships to treatment satisfaction and adherence.

METHODS: Patients in a pragmatic trial were surveyed at baseline to identify and characterize 6 potential BP medication side effect symptoms (tiredness, dizziness, foot swelling, cough, frequent urination, sexual symptoms). Reported symptoms were rated on severity (not a problem, somewhat/moderate problem, big/very big problem) and perceived relatedness to medications (yes/no). Logistic regression models used symptom severity and perceived relatedness to medications to predict BP treatment satisfaction (very satisfied to very dissatisfied) and medication adherence (changing/stopping medications).

RESULTS: Among survey responders (n = 1,719/3,071, 56%), 90% of respondents taking BP medications reported a symptom that was at least somewhat of a problem. Overall, 39% had at least one symptom that was a big or very big problem and 34% had at least one symptom that they perceived as related to their medication. For most symptoms, both higher problem severity and perceived relatedness to medication were significantly associated with lower BP treatment satisfaction and decreased adherence.

CONCLUSIONS: BP medication side effect symptoms were very common and often big problems for patients. Identifying and managing them could potentially improve BP outcomes. The brief symptom assessment developed for this study could help identify opportunities to address side effect symptoms and improve patient satisfaction and adherence.Clinical trial registration: www.

CLINICALTRIALS: gov NCT02996565.

PMID:40578923 | DOI:10.3122/jabfm.2024.240288R1