Intensive Monitoring of Adherence to Treatment Helps to Identify “True” Resistant Hypertension

Authors

  • Walnéia Aparecida De Souza PhD,

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author
  • 1 Maricene Sabha PharmD, PhD,

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author
  • 2 Fabrício De Faveri Favero PharmD, MSc,

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author
  • 2 Gun Bergsten-Mendes MD, PhD,

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author
  • 2 Juan Carlos Yugar-Toledo MD, PhD,

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author
  • and 2 Heitor Moreno Jr, MD, PhD 2

    1. From the Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil ; 1 and the Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil2
    Search for more papers by this author

  • Drs De Souza and Sabha contributed equally to this work.

Walnéia Aparecida de Souza, PhD, Department of Pharmacy, Federal University of Alfenas, 91 Manoel José de Almeida Street, Colinas Park, 37130.000 Alfenas, MG, Brazil
E-mail: walne23@yahoo.com.br

Abstract

Intensive monitoring of adherence in patients with uncontrolled hypertension was evaluated over a 6-month period. After that period, only patients well characterized as having resistant hypertension were followed for 12 months. The goal of this study was to evaluate whether adherence to a drug regimen helps to identify patients with resistant hypertension. Forty-four hypertensive patients resistant to a 3-drug regimen (average blood pressure [BP] mm Hg, mean ± standard deviation) were studied prospectively. Each patient was followed for a 12-month period. Adherence to treatment was evaluated through self-report, applying Morisky’s questionnaire and the pill count method. Ambulatory BP monitoring and office BP measures were performed. By pill count, 63.6% of the patients were adherent to treatment at the start of the survey and 94% at the end, although 59% of the patients still did not reach normal BP levels. We found that non-adherence was not associated with resistance to antihypertensive treatment. Therefore, after investigation, we concluded that patients who presented with uncontrolled arterial BP may be truly resistant hypertensive to treatment.

Ancillary