Trial reportJournal of the American Society of Hypertension : JASH
Characteristics, drug combinations and dosages of primary care patients with uncontrolled ambulatory blood pressure and high medication adherence.
Trial report in Journal of the American Society of Hypertension : JASH. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00201084 (Physician Uncertainty Reduction for Hypertension), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Physician Uncertainty Reduction for Hypertension
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2018Guideline
- Prescribing patterns of antihypertensive medications: A systematic review of literature between 2010 and 2020.Exploratory research in clinical and social pharmacy · 2023Review
- Role of home blood pressure monitoring in resistant hypertension.Clinical hypertension · 2023Review
- Immune Mechanisms of Dietary Salt-Induced Hypertension and Kidney Disease: Harry Goldblatt Award for Early Career Investigators 2020.Hypertension (Dallas, Tex. : 1979) · 2021Review
- Hypertension: Do Inflammation and Immunity Hold the Key to Solving this Epidemic?Circulation research · 2021Review
- Hypothesis: Unrecognized actions of ENaC blockade in improving refractory-resistant hypertension and residual cardiovascular risk.International Journal of Cardiology. Hypertension · 2020Article
- Reserpine Substantially Lowers Blood Pressure in Patients With Refractory Hypertension: A Proof-of-Concept Study.American journal of hypertension · 2020Article
- Antihypertensive Medication Adherence and Confirmation of True Refractory Hypertension.Hypertension (Dallas, Tex. : 1979) · 2020Article
- Renal Innervation in Resistant Hypertension: A Review of Pathophysiology and Renal Denervation as Potential Treatment.Current hypertension reviews · 2020Review
- The prevalence and predictors of resistant hypertension in high-risk overweight and obese patients: A cross-sectional study based on the 2017 ACC/AHA guidelines.Journal of clinical hypertension (Greenwich, Conn.) · 2019Article
- Masked Uncontrolled Hypertension Is Not Attributable to Medication Nonadherence.Hypertension (Dallas, Tex. : 1979) · 2019Article
- Medication adherence and treatment-resistant hypertension: a review.Drugs in context · 2019Review
- [Therapy-resistant and therapy-refractory arterial hypertension].Der Internist · 2018Article
- Refractory versus resistant hypertension: Novel distinctive phenotypes.Journal of nature and science · 2017Article
- White-Coat Effect Is Uncommon in Patients With Refractory Hypertension.Hypertension (Dallas, Tex. : 1979) · 2017Article
- Low Blood Pressure Is Associated With Greater Risk for Cardiovascular Events in Treated Adults With and Without Apparent Treatment-Resistant Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2017Observational
- Prevalence of pseudoresistant hypertension due to inaccurate blood pressure measurement.Journal of the American Society of Hypertension : JASH · 2016Article
- Refractory Hypertension: A Novel Phenotype of Antihypertensive Treatment Failure.Hypertension (Dallas, Tex. : 1979) · 2016Review
- American Society of Hypertension Scientific Statements Addressing Resistant Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
- Medication adherence and resistant hypertension.Journal of human hypertension · 2015Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Most studies on the prevalence and determinants of resistant hypertension (RH) do not account for white coat hypertension, medication non-adherence, or use of suboptimal treatment dosages. We studied the characteristics, drug combinations, and dosages of patients on at least three antihypertensives of different classes who had uncontrolled blood pressure on 24-hour ambulatory blood pressure monitoring and high medication adherence measured by electronic monitoring. The data were collected as part of the baseline measures of a hypertension control trial. Of 140 monitored primary care patients, all with uncontrolled office blood pressure, 69 (49%) were on at least three antihypertensives of different classes. Of these 69, 15 (22%) were controlled on ambulatory blood pressure monitoring, 20 (29%) were uncontrolled and non-adherent, leaving only 34 (49%) adherent to their medications and having uncontrolled ambulatory hypertension (uncontrolled RH). Thirty-one (91%) of the 34 uncontrolled RH patients were prescribed a diuretic, of which 24 were on hydrochlorothiazide 25 mg. Less than half of the patients on angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or calcium channel blocker were prescribed maximal doses of these agents. Half of the RH can be attributed to white coat effect and poor medication adherence, and all of the remaining patients were on apparently suboptimal drug combinations and/or dosages. Primary care physicians need to be educated regarding the optimal treatment of RH.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.