title: Adherence to antihypertensive therapy and therapeutic dosage of antihypertensive drugs.
abstract: Adherence to antihypertensive therapy is critical to achieving adequate blood pressure control. About half of hypertensive patients do not take their drugs as directed and the physicians often underestimate this issue. Non-adherence has important public health economic implications (numbers of visits, diagnostic procedures, prescribed drugs) and, moreover, it results in increased morbidity and mortality rates. Poor adherence can have several patients and therapy related causes. Currently, multiple different direct and indirect methods to measure therapeutic adherence are available, but, in clinical practice, there is no cost-effective and simple one. Therapeutic drug monitoring (TDM), characterized by drug (or metabolites) concentration measurement in body fluids (blood or urine), is a cost-effective direct method to assess therapeutic adherence. Despite some limitations, TDM may decrease health costs, by reducing the number of visits and by identifying those patients who would undergo unnecessary invasive procedures. Moreover, TDM can be a new alternative method to identify patients with true resistant hypertension, improving the achievement of blood pressure control In this minor revision, we would assess poor therapeutic adherence in hypertensive population, analyzing the different direct and direct available methods, with emphasis on TDM.
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy. chiara.fulcheri@gmail.com.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fulcheri
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Di Monaco
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Covella
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Perlo
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pappaccogli
authors.affiliation: Division of Internal Medicine, Hypertension Unit, AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D054796:Drug Dosage Calculations; D016903:Drug Monitoring / Q000379:methods*; D004351:Drug Resistance; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D055118:Medication Adherence; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Antihypertensive drugs; Cardiovascular diseases; Resistant hypertension; Therapeutic adherence; Therapeutic drug monitoring