Non-adherence to antihypertensive medication is very common among resistant hypertensives: results of a directly observed therapy clinic

Resistant hypertension is common among the hypertensive population with reported prevalence of 12 to 15%. These patients have a higher cardiovascular risk and consequently a poorer cardiovascular prognosis. Suboptimal adherence with antihypertensive medication is a common contributing factor in appa...

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Bibliographic Details
Published in:Journal of human hypertension 2016-02, Vol.30 (2), p.83-89
Main Authors: Hameed, M A, Tebbit, L, Jacques, N, Thomas, M, Dasgupta, I
Format: Article
Language:English
Subjects:
Antihypertensive Agents - therapeutic use
Antihypertensives
Blood pressure
Blood Pressure - drug effects
Blood Pressure Monitoring, Ambulatory
Cardiovascular diseases
Care and treatment
Complications and side effects
Directly Observed Therapy
Female
Follow-Up Studies
Humans
Hypertension
Hypertension - drug therapy
Hypertension - epidemiology
Hypertension - physiopathology
Male
Medication Adherence - statistics & numerical data
Middle Aged
Patient compliance
Patient outcomes
Patients
Prevalence
Prognosis
Retrospective Studies
Risk Factors
United Kingdom - epidemiology
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Summary:Resistant hypertension is common among the hypertensive population with reported prevalence of 12 to 15%. These patients have a higher cardiovascular risk and consequently a poorer cardiovascular prognosis. Suboptimal adherence with antihypertensive medication is a common contributing factor in apparent treatment-resistant hypertension. Patients were observed taking their medications under direct supervision at our directly observed therapy (DOT) clinic. At the DOT clinic visit, patients were fitted with a 24-h ambulatory blood pressure (ABP) monitor and each drug, at currently prescribed dose, was administered by a nurse; at an hourly interval and patient observed for 7 h. ABP readings between pre and post DOT clinic were compared. Fifty out of 56 patients had complete data on the ABP. Twenty four were female and the mean (s.d.) age was 62.0 (11.0) years. On the basis of the study methods that differentiated patients according to their BP response during the DOT clinic, twenty-five (50.0%) patients were deemed to be truly resistant (24-h ambulatory systolic blood pressure (SBP) fall
ISSN:0950-9240
1476-5527
DOI:10.1038/jhh.2015.38