medication adherence, adverse effects, and clinical outcomes among hypertensive patients receiving candesartan monotherapy in primary care settings

Hypertension is a leading global health issue, with significant implications for cardiovascular and renal health. this study aimed to evaluate the association between medication adherence, adverse drug reactions (adrs), and clinical outcomes among hypertensive patients treated with candesartan in primary healthcare settings in north sumatra, indonesia. a total of 88 hypertensive patients were included in this cross-sectional observational study, with adherence measured using the medication adherence report scale (mars-5) and adrs assessed using the naranjo algorithm. blood pressure control was monitored using standard sphygmomanometer readings, and secondary outcomes included patient-reported adrs. results showed that higher adherence was significantly associated with better blood pressure control (p = 0.012), with 68.4% of adherent patients achieving controlled bp compared to 25.8% of non-adherent patients. although mild adrs such as dizziness and fatigue were frequently reported, their occurrence was not significantly associated with adherence levels (p = 0.084). nevertheless, a non-significant trend was observed in which a greater proportion of non-adherent patients reported adrs, suggesting that patient perceptions of side effects might influence adherence behavior, though this association was not statistically confirmed in this study. the study concludes that while adherence is crucial for bp control, adrs remain a barrier to treatment continuity, and addressing these through patient education and pharmacist-led interventions is essential. further research should explore the impact of socioeconomic factors and lifestyle on adherence and clinical outcomes in hypertensive patients.