title: True Resistant Hypertension Following Observed Drug Ingestion: A Systematic Evaluation.
abstract: The authors investigated the role of poor drug adherence in treatment-resistant hypertension following observed drug ingestion in 102 patients. Median blood pressures (BPs) were 170/91 mm Hg at referral, 153/84 mm Hg prior to, and 142/79 mm Hg during a 4- to 6-hour period after drug ingestion. Median daytime ambulatory BP monitoring (ABPM) over the following 24 hours was 142/80 mm Hg. Median BP at a final follow-up clinic visit was 147/79 mm Hg. The cumulative number of patients achieving a goal of <140/90 mm Hg in clinic or <135/85 mm Hg mean on ABPM was 57 (56%), with a further nine (9%) controlled at the final follow-up clinic visit. Thus, 65% of patients achieved a systolic BP <140 mm Hg at any point immediately prior to, or after, drug ingestion; the residual 35% were considered to have true resistant hypertension. In conclusion, among patients with suspected resistant hypertension, a minority were truly treatment-resistant following observed drug ingestion and BP monitoring.
authors.affiliation: Imperial College Healthcare NHS Trust, International Centre for Circulatory Health, Hammersmith Hospital, London, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Bunker
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London - Hammersmith Campus, London, UK.
authors.forename: Choon-Lan
authors.initials: CL
authors.lastname: Chang
authors.affiliation: Imperial College Healthcare NHS Trust, International Centre for Circulatory Health, Hammersmith Hospital, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Chapman
authors.affiliation: Imperial Clinical Trials Unit, Imperial College London, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Poulter
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London - Hammersmith Campus, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Thom
authors.affiliation: Imperial College Healthcare NHS Trust, International Centre for Circulatory Health, Hammersmith Hospital, London, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Thornton-Jones
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London - Hammersmith Campus, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Sever
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents