Drs De Souza and Sabha contributed equally to this work.
Intensive Monitoring of Adherence to Treatment Helps to Identify “True” Resistant Hypertension
Article first published online: 31 MAR 2009
© 2009 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 11, Issue 4, pages 183–191, April 2009
How to Cite
De Souza, W. A., Sabha, M., De Faveri Favero, F., Bergsten-Mendes, G., Yugar-Toledo, J. C. and Moreno, H. (2009), Intensive Monitoring of Adherence to Treatment Helps to Identify “True” Resistant Hypertension. The Journal of Clinical Hypertension, 11: 183–191. doi: 10.1111/j.1751-7176.2009.00102.x
- Issue published online: 13 APR 2009
- Article first published online: 31 MAR 2009
- Manuscript received August 4, 2008; revised February 7, 2009; accepted February 10, 2009
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.