title: Pharmaceutical care program for patients with uncontrolled hypertension. Report of a double-blind clinical trial with ambulatory blood pressure monitoring.
abstract: BACKGROUND
  Pharmaceutical care programs may be an option to improve blood pressure (BP) control in patients with uncontrolled hypertension. The aim of this study was to evaluate the efficacy of pharmaceutical care programs in treating patients with resistant hypertension.
  
  
  METHODS
  In a double-blind randomized clinical trial, 71 patients with uncontrolled BP were enrolled in a pharmaceutical care program or in a control group and underwent a series of cognitive tests. The primary outcome was change in ambulatory BP (ABP) between the baseline evaluation and the final visit 6 months later. The secondary outcomes were the frequency of drug-related problems and adherence as determined by plasma levels of hydrochlorothiazide.
  
  
  RESULTS
  The delta-values between the intervention and control groups for ABP in the different daily periods, with the corresponding 95% confidence limits, adjusted for age and baseline BP were: 3 (-1 to 5), 2 (-2 to 4), and 5 (-1 to 6) mm Hg for 24 h, daily and nightly systolic BP, respectively. The corresponding values for diastolic BP were 1 (-1 to 3), 0 (-2 to 2), and 3 (-1 to 4) mm Hg, respectively. Hydrochlorothiazide was detected in the plasma in 21 of 27 patients in the intervention group that attended to all appointments and 24 of 30 patients in the control group (P = .904).
  
  
  CONCLUSIONS
  The pharmaceutical care program tested in this trial was feasible and showed a trend for better BP control in patients with uncontrolled hypertension.
authors.affiliation: Department of Drug Production and Control, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Mauro Silveira
authors.initials: MS
authors.lastname: de Castro
authors.forename: Flávio Danni
authors.initials: FD
authors.lastname: Fuchs
authors.forename: Melissa Costa
authors.initials: MC
authors.lastname: Santos
authors.forename: Paulo
authors.initials: P
authors.lastname: Maximiliano
authors.forename: Miguel
authors.initials: M
authors.lastname: Gus
authors.forename: Leila Beltrami
authors.initials: LB
authors.lastname: Moreira
authors.forename: Maria Beatriz Cardoso
authors.initials: MB
authors.lastname: Ferreira
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000458:organization & administration*; D015397:Program Evaluation; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents