Treatment Adherence, Lifestyle Behaviour, and Complication Profile Among Urban Hypertensive Patients: A Community-Based Cross-Sectional Study

Background: Cardiovascular complication largely attributed to the combination of poor adherence to therapy, unhealthy lifestyle habits and presence of end organs is one of the greatest preventable causes of cardiovascular mortality and morbidity worldwide, but the same triad of therapy adherence, lifestyle behaviour, and end organ complication remains inadequately described in urban Indian community settings. The aim of the study was to identify the prevalence and profile of complications associated with hypertension in an urban field practice setting in adults and test associations between medication adherence, dietary and physical activity behaviour and the presence of these complications. Material and Methods: A community based cross sectional study was done amongst 330 confirmed hypertensive adults by simple random sampling from a hypertension register in a field practice area in the urban area. The Morisky Medication Adherence Scale (MMAS) was used as a tool to evaluate medication adherence. Blood pressure and anthropometric Indices were recorded using calibrated instruments according to the standard procedure. Chi-square and logistic regression (p< .05 significance level) were used to test associations. Results: Hypertension-related complications were identified in 58 participants (17.6%). Cardiovascular disease was the most prevalent complication (3.9%), followed by nephropathy and neuropathy (each 2.4%), stroke (1.8%), and retinopathy (1.5%). High medication adherence was documented in 69.1% of participants. Forgetfulness was the principal barrier to non-adherence (56.9%). Overall adherence category did not differ significantly between those with and without complications (χ² = 0.673, p > 0.05); however, adherence type was significantly associated with complication pattern (p = 0.022), with low adherence over-represented among cardiovascular disease (9.7%) and stroke (6.5%) cases. Healthy dietary practice was strongly protective against complications (χ² = 12.73, p < 0.001). Conclusion: Despite high adherence rates, complications remain common, showing that medicines alone are not enough. Improving diet quality and addressing specific adherence–complication links should be priority targets for comprehensive, community based interventions.

Keywords: Hypertension; medication adherence; lifestyle modification; cardiovascular complications; urban community; MMAS; India.