Document Detail

Difficult-to-control arterial hypertension or uncooperative patients? The assessment of serum antihypertensive drug levels to differentiate non-responsiveness from non-adherence to recommended therapy.
MedLine Citation:
PMID:  20882030     Owner:  NLM     Status:  In-Process    
Difficult-to-control arterial hypertension is a common medical problem that may result from severe hypertensive disease or from poor adherence to the recommended medical treatment. The identification of non-adherent patients is challenging, especially when non-adherence is intentional. The current report describes the use of serum levels of prescribed antihypertensive drugs to evaluate the adherence in individuals with difficult-to-control arterial hypertension. Serum drug levels (SDLs) were evaluated by liquid chromatography with mass spectrometry. The chromatographic separation was performed on a reversed-phase column with a gradient flow of the mobile phase. The detection of analyzed substances was accomplished on a linear ion-trap mass spectrometer. The subjects were labeled as non-adherent when the serum level of at least one of the evaluated drugs was below the limit of quantification. The study used data from 84 patients with arterial hypertension who underwent SDL assessment to verify compliance with the recommended treatment. Patients who presented with uncontrolled blood pressure despite the recommended combination of at least three antihypertensives were enrolled in the analysis. Based on the evaluation of the SDLs, all of the evaluated drugs were found in the sera of 29 (34.5%) of the study patients. In the remaining 55 (65.5%) patients, non-adherence was diagnosed. None of the prescribed antihypertensive drugs was detected in the sera of the 29 (34.5%) patients. Our data suggest that an assessment of SDLs might be helpful before an extensive evaluation is initiated for difficult-to-control hypertension.
Jiri Ceral; Vilma Habrdova; Viktor Vorisek; Marcel Bima; Radek Pelouch; Miroslav Solar
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-30
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  34     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  87-90     Citation Subset:  IM    
Department of Internal Medicine, Medical Faculty Hradec Kralove Charles University Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
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MeSH Terms
Comment In:
Hypertens Res. 2011 Jan;34(1):39-40   [PMID:  21048777 ]
Hypertens Res. 2011 Jan;34(1):41-2   [PMID:  21107331 ]

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