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
Abstract
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 use of serum levels of prescribed antihypertensive drugs to evaluate the adherence in individuals with difficult-to-control arterial hypertension was descibed.
Serum drug levels (SDLs) were evaluated by liquid chromatography with mass spectrometry. Eighty-four patients who presented with uncontrolled blood pressure despite the recommended combination of at least three antihypertensives were enrolled in the study.
In 55 (65.5%) patients, non-adherence was diagnosed. Our data suggest that an assessment of SDLs might be helpful before an extensive evaluation is initiated for difficult-to-control hypertension.