Nonadherence to antihypertensive medications is related to pill burden in apparent treatment-resistant hypertensive individuals.

Lawson, Alexander J and Hameed, Mohammed Awais and Brown, Roger and Cappuccio, Francesco P and George, Stephen and Hinton, Thomas and Kapil, Vikas and Lenart, Jane and Lobo, Melvin D and Martin, Una and Menon, Madhavan and Nightingale, Angus and Rylance, Paul B and Webb, David J and Dasgupta, Indranil (2020) Nonadherence to antihypertensive medications is related to pill burden in apparent treatment-resistant hypertensive individuals. Journal of hypertension. ISSN 1473-5598.

Full text not available from this repository.
Official URL: https://journals.lww.com/jhypertension/Abstract/pu...

Abstract

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.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 13 Mar 2020 15:28
Last Modified: 13 Mar 2020 15:28
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2931

Actions (login required)

View Item View Item