Different Methods of Adherence to Therapy in Patients With Resistant Hypertension (Pilot Study)

Poor adherence to treatment is one of the reasons for not reaching the target levelof blood pressure and the consequences in the form of the development of cardiovascularcomplications.Aim – to analysis adherence to treatment of patients with resistant arterial hypertensionby various methods and to determine ways to overcome non-adherence to treatment.Material and methods. 12 patients with resistant hypertension were included into the study.Men and women over the age of 18 were included, provided that the average level of officeblood pressure was greater than 140/90 mm Hg when taking 3 or more antihypertensivedrugs included with fixed combination of valsartan, amlodipine, hydrochlorotiazide. Todetermine adherence to treatment, questionnaires and determination of drugs in urinewere performed in the central laboratory using the chromatography method. All patientsunderwent the following studies at the beginning: measurement of office SBP, DBP, andheart rate. The duration of observation was 12 months.Results. The average age of the patients was 58,67±13,68 years. Men and women –50 %/50 % (n=6/6). The degree of decrease in office blood pressure after 12 monthsof treatment was for SBP/DBP – 35.5/16.7 mm Hg, (p <0.001 for both values) againsta background of a fixed triple combination of valsartan/amlodipine/hydrochlorothiazide.According to the determination of drugs in the urine, we found that 25 % of patients(n=3) did not take drugs at all. The result of the survey showed the need to increase the awareness of patients about the symptoms of the disease. Survey data indicate the needto clarify the necessity to ensure continuous, long-term self-monitoring of blood pressureand taking antihypertensive drugs by keeping a diary in order to improve adherence andeffectiveness of treatment.Conclusion. In 25 % of patients with resistant arterial hypertension, drugs were notdetected in the urine at all, that is, they were nonadherence to therapy.