title: Intensive monitoring of adherence to treatment helps to identify "true" resistant hypertension.
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.
authors.affiliation: Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil. walne23@yahoo.com.br
authors.forename: Walnéia Aparecida
authors.initials: WA
authors.lastname: de Souza
authors.forename: Maricene
authors.initials: M
authors.lastname: Sabha
authors.forename: Fabrício
authors.initials: F
authors.lastname: de Faveri Favero
authors.forename: Gun
authors.initials: G
authors.lastname: Bergsten-Mendes
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Yugar-Toledo
authors.forename: Heitor
authors.initials: H
authors.lastname: Moreno
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents