title: Assessment of drug compliance in patients with high blood pressure resistant to antihypertensive therapy.
abstract: The persistence of high blood pressure under antihypertensive treatment (resistant hypertension) entails an increased cardiovascular risk. It occurs in three of ten treated hypertensive patients, and has several possible contributing factors, notably insufficient therapeutic adherence. There are a number of ways to evaluate whether patients take their medication as prescribed. These include interviewing the patient, pill counting, prescription follow-up, assay of drugs in blood or urine, and use of electronic pill dispensers. None is perfect. However, the essential is to discuss with the patient the importance of complying with the treatment as soon as it is prescribed for the first time, and not waiting for the appearance of resistant hypertension. The measurement of blood pressure outside the medical office and the monitoring of adherence may help to identify patients in whom hypertension is truly resistant and so to tailor the measures required to improve the control of blood pressure in the most appropriate manner.
authors.affiliation: Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. Bernard.Waeber@chuv.ch
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.forename: François
authors.initials: F
authors.lastname: Feihl
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D016903:Drug Monitoring; D004351:Drug Resistance; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D055118:Medication Adherence; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents