AI Article Synopsis
- - The study aimed to assess how many patients with hypertension were not following their prescribed antihypertensive drugs (AHDs) in nephrology and vascular outpatient clinics, as nonadherence can lead to pseudo-resistant hypertension.
- - Out of 142 patients, the overall adherence rate to AHDs was found to be 78.2%, with irbesartan showing the highest adherence (100%) and bumetanide the lowest (69%).
- - Kidney transplant patients were significantly more likely to adhere to their AHDs, with an adherence rate of 85.7% compared to 64.0% in non-transplanted patients, highlighting kidney transplantation as a key factor for improving adherence.
Article Abstract
Background: Nonadherence to antihypertensive drugs (AHDs) is a major contributor to pseudo-resistant hypertension. The primary objective of this study was to determine the prevalence of nonadherence to AHDs among patients visiting the nephrology and vascular outpatient clinics.
Methods: Patients were eligible to participate in this prospective observational study if they used at least two AHDs that could be measured with a validated UHPLC-MS/MS method and had an office blood pressure at least 140 and/or at least 90 mmHg. For resistant hypertension, included patients had to use at least three AHDs including a diuretic or four AHDs. Adherence was assessed by measuring drug concentrations in blood. The complete absence of drug in blood was defined as nonadherence. A posthoc analysis was performed to determine the influence of a having a kidney transplant on the adherence rates.
Results: One hundred and forty-two patients were included of whom 66 patients fulfilled the definition of resistant hypertension. The overall adherence rate to AHDs was 78.2% ( n = 111 patients), with the highest adherence rate for irbesartan (100%, n = 9) and lowest adherence rate for bumetanide ( n = 69%, n = 13). In further analysis, only kidney transplantation could be identified as an important factor for adherence (adjusted odds ratio = 3.35; 95% confidence interval 1.23-9.09). A posthoc analysis showed that patients with a kidney transplant were more likely to be adherent to AHDs (non-KT cohort 64.0% vs. KT-cohort 85.7%, χ 2 (2) = 10.34, P = 0.006).
Conclusion: The adherence rate to AHDs in hypertensive patients was high (78.2%) and even higher after a kidney transplant (85.7%). Furthermore, patients after kidney transplant had a lower risk of being nonadherent to AHDs.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328507 | PMC |
| http://dx.doi.org/10.1097/HJH.0000000000003459 | DOI Listing |
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