The Association Between Blood Pressure Control and Renal Function in Hypertensive Patients: Evidence from a Community Health Center in Indonesia

Research

Penulis

  • Muhamad Ibnu Aziz Medical Intern, Pakem Community Health Center, Sleman, Yogyakarta, Indonesia https://orcid.org/0009-0005-3473-8630
  • Tania Mutia Chaerunisa Medical Intern, Pakem Community Health Center, Sleman, Yogyakarta, Indonesia
  • Dentista Admirasari Medical Intern, Pakem Community Health Center, Sleman, Yogyakarta, Indonesia
  • Medical Intern, Pakem Community Health Center, Sleman, Yogyakarta, Indonesia Tasnim Medical Intern, Pakem Community Health Center, Sleman, Yogyakarta, Indonesia https://orcid.org/0009-0003-4745-7235

DOI:

https://doi.org/10.55175/cdk.v53i09.2402

Kata Kunci:

Blood pressure control, hypertension, medication adherence, renal function

Abstrak

Introduction: Adherence to antihypertensive therapy (AHT) plays a crucial role in achieving optimal blood pressure control and preventing long-term complications, including impaired renal function. This study aimed to analyze the association between medication adherence and blood pressure control and to evaluate renal function in hypertensive patients. Methods: This observational analytic study used a retrospective cohort design. This study was conducted at the Pakem Community Health Center using medical records of hypertensive patients participating in the Chronic Disease Management Program (Program Pengelolaan Penyakit Kronis [PROLANIS]). Blood pressure control was determined based on the average blood pressure measurements over six months. Medication adherence was assessed using the medication possession ratio (MPR) from January to June 2025, while renal function was assessed based on changes in the estimated glomerular filtration rate (ΔeGFR) in January and July 2025. Statistical analyses were performed using IBM SPSS Statistics version 26. Statistical significance was defined as p < 0.05. Results: A total of 101 patients met the inclusion criteria. Most patients had high adherence (78.2%) and controlled blood pressure (72.3%). The proportion of blood pressure control was higher in the high-adherence group than in the low-adherence group (81.0% vs. 40.9%; p < 0.001), patients with high adherence had 6.16 times higher odds of achieving blood pressure control (OR 6.16; 95% CI 2.22–17.08). No significant difference in ΔeGFR was observed between patients with controlled and uncontrolled blood pressure (3.25 ± 7.66 vs. 3.93 ± 10.19 mL/min/1.73 m²; p = 0.970). Conclusion: Medication adherence was significantly associated with blood pressure control, whereas changes in renal function did not differ significantly between patients with controlled and uncontrolled blood pressure.

Unduhan

Data unduhan belum tersedia.

Referensi

Deepshikha, Mathur P, Monika, Jhawat V, Shekhar S, Dutt R, et al. An overview of hypertension: pathophysiology, risk factors, and modern management. Curr Hypertens Rev. 2025 May;21(2):64–81. doi: 10.2174/0115734021349254250224074832.

World Health Organization. Hypertension [Internet]. Geneva: WHO; 2025 [cited 2026 Feb 24]. Available from: https://www.who.int/en/newsroom/fact-sheets/detail/hypertension.

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957–80. doi: 10.1016/S0140-6736(21)01330-1.

Muharram FR, Widyahening IS, Danaei G. Hypertension care performance in Indonesia: evidence from three waves of nationally representative cross-sectional surveys. BMJ Open. 2025 Dec;15(12):e109588. doi: 10.1136/bmjopen-2025-109588

Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020 Apr;16(4):223–37. doi: 10.1038/s41581-019-0244-2.

Peng X, Wan L, Yu B, Zhang J. The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies. BMC Cardiovasc Disord. 2025 Mar 3;25(1):145. doi: 10.1186/s12872-025-04538-6.

Jo S, Um T, Shin J, Lee D, Park K, Son M. Factors associated with suboptimal adherence to antihypertensive medication: Cross-sectional study using nationally representative databases. Heliyon. 2024 Oct;10(19):e38531. doi: 10.1016/j.heliyon.2024.e38531.

Belayachi S, Boukhari FZ, Essayagh F, Terkiba O, Zohoun A, Essayagh M, et al. Non-adherence to antihypertensive drugs and its risk factors among hypertensive patients, Marrakech, Morocco. PLOS Glob Public Health. 2024 Aug 27;4(8):e0002774. doi: 10.1371/journal.pgph.0002774.

Tan CS, Hassali MA, Neoh CF, Saleem F. A qualitative exploration of hypertensive patients’ perception towards quality use of medication and hypertension management at the community level. Pharm Pract (Granada). 2017;15(4):1074. doi: 10.18549/PharmPract.2017.04.1074.

Kurniawan IN, Yuantari R, Sulistyowatiningsih E, Faizah AK, Ningrum VDA. Pengembangan dan validasi kuesioner untuk menilai miskonsepsi tentang pengobatan pada hipertensi dan diabetes melitus dengan kejadian gagal ginjal. J Sains Farm Klin. 2020 Dec 28;7(3):202. https://doi.org/10.25077/jsfk.7.3.202-209.2020

Beall RF, Leung AA, Quinn AE, Salmon C, Scory TD, Bresee LC, et al. Laboratory testing and antihypertensive medication adherence following initial treatment of incident, uncomplicated hypertension: a real-world data analysis. J of Clinical Hypertension. 2022 Oct;24(10):1316–26. doi: 10.1111/jch.14567.

Pakem Community Health Center. PRO HIT [Internet]. 2024 [cited 2026 Jun 30]. Available from: https://pkmpakem.slemankab.go.id/prohit/.

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/4634/2021 Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Hipertensi Dewasa. Jakarta: Kemenkes RI; 2021.

Kozma CM, Dickson M, Phillips AL, Meletiche DM. Medication possession ratio: implications of using fixed and variable observation periods in assessing adherence with disease-modifying drugs in patients with multiple sclerosis. Patient Prefer Adherence. 2013;7:509–16. doi:10.2147/PPA.S40736.

Andrade SE, Kahler KH, Frech F, Chan KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006 Aug;15(8):565–74; discussion 575–7. doi: 10.1002/pds.1230.

Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, et al. New creatinine- and cystatin C-based equations to estimate GFR without ace. N Engl J Med. 2021 Nov 4;385(19):1737–49. doi: 10.1056/NEJMoa2102953.

Tatar R, Marusteri MS, Iancu DG, Mares RG, Moldovan DA, Varga A, et al. Adherence, persistence, and blood pressure control in hypertensive patients: a cross-sectional study in Mures County, Romania. Medical Sciences. 2025 Aug 8;13(3):119. doi: 10.3390/medsci13030119.

Turki F, Turki I, Jedidi J, Said H. Medication adherence, blood pressure control, knowledge, self-care and self-efficacy among Tunisian hypertensive patients. TONURSJ. 2024 Oct 23;18(1):e18744346337256. doi: 10.2174/0118744346337256240911114624.

Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020 Feb;75(2):285–92. doi: 10.1161/HYPERTENSIONAHA.119.14240.

Erlina Putri T, Syamsu Hidayat M, Ani Marwati T. Efektivitas pelayanan program penyakit kronis dalam mengontrol tekanan darah pada peserta Prolanis yang mengalami hipertensi. MTPHJ. 2022 Jun 21;5(2):148–59. doi: 10.33086/mtphj.v5i2.2746.

Judson GL, Rubinsky AD, Shlipak MG, Katz R, Kramer H, Jacobs DR, et al. Longitudinal blood pressure changes and kidney function decline in persons without chronic kidney disease: findings from the MESA study. Am J Hypertens. 2018 Apr 13;31(5):600–8. doi: 10.1093/ajh/hpx177.

Yu Z, Rebholz CM, Wong E, Chen Y, Matsushita K, Coresh J, et al. Association between hypertension and kidney function fecline: The Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis. 2019 Sep;74(3):310–9. doi: 10.1053/j.ajkd.2019.02.015.

Saputra PBT, Lamara AD, Saputra ME, Maulana RA, Hermawati IE, Achmad HA, et al. Diagnosis dan terapi non-farmakologis pada hipertensi. Cermin Dunia Kedokteran. 2023 May 31;50(6):322–30. https://doi.org/10.55175/cdk.v50i6.624.

Sarastuti AW, Widyantoro B. Latihan fisik bagi penderita hipertensi. Cermin Dunia Kedokteran. 2018 Dec 3;45(12):930–3. https://doi.org/10.55175/cdk.v45i12.687.

Kusumamardhika R, Utami AP, Darmawan H. Assessment of knowledge, attitude, and practice (KAP) towards hypertension in the elderlies. Cermin Dunia Kedokteran. 2023 Jul 3;50(7):350–3. https://doi.org/10.55175/cdk.v50i7.951.

Diterbitkan

2026-09-18

Cara Mengutip

Aziz, M. I., Chaerunisa, T. M., Admirasari, D., & Tasnim, M. I. P. C. H. C. S. Y. I. (2026). The Association Between Blood Pressure Control and Renal Function in Hypertensive Patients: Evidence from a Community Health Center in Indonesia: Research. Cermin Dunia Kedokteran, 53(09), 584–589. https://doi.org/10.55175/cdk.v53i09.2402