Featured Research

from universities, journals, and other organizations

One in 4 people with high blood pressure not taking their meds properly

Date:
April 2, 2014
Source:
BMJ-British Medical Journal
Summary:
Around one in four people prescribed drugs to lower longstanding blood pressure either just doesn't take them at all or only part of the time, suggests a study of a simple technique designed to find out why drug treatment might not be working in these patients. Those referred for further treatment, because of "resistant hypertension" were most likely not to be taking their tablets properly, the findings show.

Around one in four people prescribed drugs to lower longstanding blood pressure either just doesn't take them at all or only part of the time, suggests a study of a simple technique designed to find out why drug treatment might not be working in these patients, and published online in the journal Heart.

Those referred for further treatment, because of "resistant hypertension" were most likely not to be taking their tablets properly, the findings show.

It is well known that patients with common longstanding conditions don't always comply with their drug treatment, and high blood pressure is no exception. But until now there has been no easy way of finding out who is simply not taking their prescribed tablets and who is genuinely not responding to treatment.

The authors therefore analysed the urine samples of 208 patients with high blood pressure attending a specialist hypertension clinic. Some 125 were new referrals from primary care; 66 were follow up patients whose blood pressure control was poor; and 17 had been referred for renal denervation.

Renal denervation is a procedure that cauterises nerve endings in the kidney artery walls, with the aim of lowering longstanding high blood pressure after comprehensive drug treatment has apparently failed to do so, known as "resistant hypertension."

The urine samples were analysed for a wide range of the most commonly prescribed drugs to treat high blood pressure, using a widely available technique called high performance liquid chromatography-tandem mass spectrometry or HP LC-MS/MS, for short.

One in four of the 208 patients was not taking their blood pressure drugs properly: one in 10 (10%) was not complying with treatment at all; while a further one in seven (15%) was only taking them part of the time.

The greatest proportion of complete "untakers" was found among those referred for renal denervation, almost one in four of whom had no evidence whatsoever of any antihypertensive drugs in their urine.

Furthermore, the average number of drugs picked up in the urine samples was lower than the number actually prescribed. And there was a direct correlation between blood pressure readings and the number of drugs detected, with the lowest readings among those taking all their prescribed meds.

The authors acknowledge their sample size is small, but point to "alarmingly high levels" of complete non-adherence to prescribed drugs.

"A majority of these patients in any secondary/tertiary care centre would routinely undergo many additional tests and procedures in search of the explanation for their apparent unresponsiveness to standard therapy prescribed in primary care," they emphasise, adding that in around one in five cases, HP LC-MS/MS could potentially avoid all this.

In an accompanying editorial, Professor Morris Brown, of the Clinical Pharmacology Unit at the University of Cambridge, says that the technique could "solve at a stroke the problem of monitoring adherence and should rapidly transform practice."

"Non-adherence to therapy, and its recognition, is a particular problem in hypertension because of its chronicity and asymptomatic nature," he writes.

"That most patients do not take all their drugs all the time was probably predictable," he suggests. "But that 23% of those referred for renal denervation have no detectable drug in their urine was a shock," he adds, especially given that there are considerable doubts about the effectiveness of this procedure, to say nothing of the waste of resources involved.


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal References:

  1. M. J. Brown. Resistant hypertension: resistance to treatment or resistance to taking treatment? Heart, 2014; DOI: 10.1136/heartjnl-2014-305540
  2. M. Tomaszewski, C. White, P. Patel, N. Masca, R. Damani, J. Hepworth, N. J. Samani, P. Gupta, W. Madira, A. Stanley, B. Williams. High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Heart, 2014; DOI: 10.1136/heartjnl-2013-305063

Cite This Page:

BMJ-British Medical Journal. "One in 4 people with high blood pressure not taking their meds properly." ScienceDaily. ScienceDaily, 2 April 2014. <www.sciencedaily.com/releases/2014/04/140402212529.htm>.
BMJ-British Medical Journal. (2014, April 2). One in 4 people with high blood pressure not taking their meds properly. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2014/04/140402212529.htm
BMJ-British Medical Journal. "One in 4 people with high blood pressure not taking their meds properly." ScienceDaily. www.sciencedaily.com/releases/2014/04/140402212529.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins