ArticleJournal of human hypertension2016
Non-adherence to antihypertensive medication is very common among resistant hypertensives: results of a directly observed therapy clinic.
Article in Journal of human hypertension, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2018Guideline
- The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis.BMJ open · 2016Pooled it
- Physiologic profiling using plasma renin activity and aldosterone on blood pressure control among Ghanaian stroke survivors: A pilot trial.Equity neuroscience · 2025Article
- Novel pharmacological approaches to lowering blood pressure and managing hypertension.Nature reviews. Cardiology · 2025Review
- Association between the urinary sodium-to-potassium ratio and apparent treatment-resistant hypertension in Japanese patients with non-dialysis dependent chronic kidney disease: the Fukuoka Kidney disease Registry study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Medical Measures in Hypertensives Considered Resistant.American journal of hypertension · 2024Article
- Measurement Tools and Utility of Hair Analysis for Screening Adherence to Antihypertensive Medication.Global heart · 2023Review
- Cross-cultural adaptation of the Spanish MINICHAL instrument into English for use in the United Kingdom.Health and quality of life outcomes · 2022Article
- Evidence of Nonadherence in Cases of Pseudoresistant Hypertension.Integrated blood pressure control · 2021Article
- Medication Non-adherence: a Major Cause of Resistant Hypertension.Current cardiology reports · 2020Review
- Do patients or their physicians more accurately assess long-term risk associated with hypertension? A population-based study.Scandinavian journal of primary health care · 2020Article
- Rapid treatment of moderate to severe hypertension using a novel protocol in a single-centre, before and after interventional study.Journal of human hypertension · 2020Article
- Improvement of Blood Pressure Control by Adherence Check in Patients With Apparent Treatment-Resistant Hypertension: A Case Series.Clinical medicine insights. Case reports · 2020Article
- Resistant Hypertension: Where are We Now and Where Do We Go from Here?Integrated blood pressure control · 2020Review
- Renal Denervation Update From the International Sympathetic Nervous System Summit: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2019Review
- Medication adherence and treatment-resistant hypertension: a review.Drugs in context · 2019Review
- Hypertension - state of the art 2017.Clinical medicine (London, England) · 2017Article
- How to Screen for Non-Adherence to Antihypertensive Therapy.Current hypertension reports · 2016Review
- Device-based Therapy for Hypertension.Current hypertension reports · 2016Review
- Renal Denervation in Patients With Uncontrolled Hypertension and Confirmed Adherence to Antihypertensive Medications.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Resistant hypertension is common among the hypertensive population with reported prevalence of 12 to 15%. These patients have a higher cardiovascular risk and consequently a poorer cardiovascular prognosis. Suboptimal adherence with antihypertensive medication is a common contributing factor in apparent treatment-resistant hypertension. Patients were observed taking their medications under direct supervision at our directly observed therapy (DOT) clinic. At the DOT clinic visit, patients were fitted with a 24-h ambulatory blood pressure (ABP) monitor and each drug, at currently prescribed dose, was administered by a nurse; at an hourly interval and patient observed for 7 h. ABP readings between pre and post DOT clinic were compared. Fifty out of 56 patients had complete data on the ABP. Twenty four were female and the mean (s.d.) age was 62.0 (11.0) years. On the basis of the study methods that differentiated patients according to their BP response during the DOT clinic, twenty-five (50.0%) patients were deemed to be truly resistant (24-h ambulatory systolic blood pressure (SBP) fall <5 mm Hg) and the remaining 25 were deemed to have clinically significant non-adherence (24-h ambulatory SBP fall ⩾5 mm Hg) to prescribed therapy. In non-adherent patients, the mean 24-h ambulatory BP drop observed was 19.5/9.4 mm Hg (P<0.001 for both). Our results suggest that non-adherence is very common among patients considered to have apparent treatment-resistant hypertension. DOT clinic can be an effective method of identifying the truly resistant hypertensive patients.
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