Nonadherence to antihypertensive medications is related to pill burden in apparent treatment-resistant hypertensive individuals
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Le résumé fourni par la source
OBJECTIVE: Nonadherence to medication is present in at least 50% of patients with apparent treatment-resistant hypertension. We examined the factors associated with nonadherence as detected by a liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based urine antihypertensive drug assay. METHODS: All urine antihypertensive test results, carried out for uncontrolled hypertension (BP persistently >140/90 mmHg) between January 2015 and December 2016 at a single toxicology laboratory were analysed. Drugs detected were compared with the antihypertensive drugs prescribed. Patients were classified as adherent (all drugs detected), partially nonadherent (at least one prescribed drug detected) or completely nonadherent (no drugs detected). Demographic and clinical parameters were compared between the adherent and nonadherent groups. Binary logistic regression analysis was performed to determine association between nonadherence and demographic and clinical factors. RESULTS: Data on 300 patients from nine hypertension centres across the United Kingdom were analysed. The median age was 59 years, 47% women, 71% Caucasian, median clinic BP was 176/95 mmHg and the median number of antihypertensive drugs prescribed was four. One hundred and sixty-six (55%) were nonadherent to prescribed medication with 20% of these being completely nonadherent. Nonadherence to antihypertensive medication was independently associated with younger age, female sex, number of antihypertensive drugs prescribed, total number of all medications prescribed (total pill burden) and prescription of a calcium channel blocker. CONCLUSION: This LC-MS/MS urine analysis-based study suggests the majority of patients with apparent treatment-resistant hypertension are nonadherent to prescribed treatment. Factors that are associated with nonadherence, particularly pill burden, should be taken into account while treating these patients.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Nonadherence to antihypertensive medications is related to pill burden in apparent treatment-resistant hypertensive individuals
- Date Crossref
- 01/06/2020
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Heartlands Hospital pays non établi dans la noticeÉtablissement de santé
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The Queen's Medical Research Institute pays non établi dans la noticeOrganisme public
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University Hospitals Coventry and Warwickshire NHS Trust pays non établi dans la noticeÉtablissement de santé
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University of Warwick Warwick Medical School pays non établi dans la noticeUniversité ou école supérieure
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University Hospitals Bristol NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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William Harvey Research Institute pays non établi dans la noticeStructure de recherche
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Queen Elizabeth Hospital Birmingham pays non établi dans la noticeÉtablissement de santé
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University Hospitals of North Midlands NHS Trust pays non établi dans la noticeÉtablissement de santé
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The Royal Wolverhampton NHS Trust pays non établi dans la noticeÉtablissement de santé
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University of Edinburgh BHF Centre of Research Excellence pays non établi dans la noticeUniversité ou école supérieure
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Barts Heart Centre & Queen Mary University London William Harvey Research Institute pays non établi dans la noticeUniversité ou école supérieure
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Twitter handle: @idasgupta7 pays non établi dans la noticeInstitution
Heartlands Hospital, The Queen's Medical Research Institute et University Hospitals Coventry and Warwickshire NHS Trust, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.