Why the study?
What is the prevalence and what are the correlates of low medication adherence in patients with apparent treatment-resistant hypertension?
What is the prevalence and what are the correlates of low medication adherence in patients with apparent treatment-resistant hypertension?
Only a small percentage of patients with apparent treatment-resistant hypertension have low medication adherence, suggesting that true resistance or other factors are the primary drivers.
Low adherence remains uncommon in aTRH; leaves open whether other factors predominate and warrants prospective confirmation.
Low medication adherence may explain part of the high prevalence of apparent treatment-resistant hypertension (aTRH). The authors assessed medication adherence and aTRH among 4026 participants taking ≥ 3 classes of antihypertensive medication in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) trial using the 4-item Morisky Medication Adherence Scale (MMAS). Low adherence was defined as an MMAS score ≥ 2. Overall, 66% of participants taking ≥ 3 classes of antihypertensive medication had aTRH. Perfect adherence on the MMAS was reported by 67.8% and 70.9% of participants with and without aTRH, respectively. Low adherence was present among 8.1% of participants with aTRH and 5.0% of those without aTRH (P<.001). Among those with aTRH, female sex, residence outside the US stroke belt or stroke buckle, physical inactivity, elevated depressive symptoms, and a history of coronary heart disease were associated with low adherence. In the current study, a small percentage of participants with aTRH had low adherence.
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Irvin et al. (2012) studied this question.
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