Key result
Episodic lapses in adherence did not have a direct impact on blood pressure among patients with mild hypertension on single-drug therapy conforming to FDA dosing guidelines.
Why the study?
Do antihypertensive monotherapy regimens conforming to FDA dosing guidelines prevent loss of blood pressure control during sporadic lapses in adherence in patients with high blood pressure?
Observational (n=169)
Do antihypertensive monotherapy regimens conforming to FDA dosing guidelines prevent loss of blood pressure control during sporadic lapses in adherence in patients with high blood pressure?
Antihypertensive monotherapy regimens conforming to FDA dosing guidelines may maintain blood pressure control even during episodic lapses in patient adherence.
Answers are grounded in this paper and cite their sources.
May support BP control with FDA-conformant monotherapy despite lapses; hypothesis-generating and requires randomized confirmation.
OBJECTIVES: To evaluate if antihypertensive regimens that conform to present FDA guidelines by maintaining > or = 50% of their peak effect at the end of the dosing interval protect patients during sporadic lapses in adherence. METHODS: 169 patients on monotherapy for high blood pressure underwent electronic adherence monitoring for 3 months. Blood pressures were measured during non-study office visits and were retrieved from automated medical records. Questionnaires were used to obtain other covariate information. The ratio of the dosing interval to the half-life of drug activity (I') was used to capture conformity with FDA guidelines. Data analysis focused on the interaction between I' and the impact on blood pressure of delayed dosing. RESULTS: The average (+/- standard deviation) blood pressure during the study was 139.0(+/- 12.0)/85.0(+/- 6.9) mm Hg. Lisinopril followed by sustained-release verapamil, atenolol, and hydrochlorothiazide were the most frequently prescribed agents. The majority of regimens (99%) conformed to FDA dosing guidelines. Of the patients 23% missed a dose before their blood pressure check. Non-adherence, however, did not have a direct impact on blood pressure, and no interaction with I' of was detected. CONCLUSIONS: Among patients with relatively mild hypertension on single-drug therapy, regimens that conform to current FDA dosing guidelines may prevent losses of blood pressure control during episodic lapses of adherence. These findings should be replicated in other patient populations with standardized blood pressure measurement to confirm their validity.
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Choo et al. (2000) conducted an observational in high blood pressure (n=169). Antihypertensive non-adherence was evaluated on Blood pressure. Episodic lapses in adherence did not have a direct impact on blood pressure among patients with mild hypertension on single-drug therapy conforming to FDA dosing guidelines.
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