Just one in five patients seeking specialty care for resistant hypertension were found to be taking all prescribed medications during a trial undertaken in the Netherlands.
The SYMPATHY trial , which was originally designed to assess renal sympathetic denervation as a new treatment for therapy-resistant hypertension, randomised 139 patients to renal denervation (RDN) plus usual care compared to medication alone. Adherence to blood pressure lowering drugs was assessed at baseline and follow-up using blood samples drawn synchronously with blood pressure (BP) measurements. Patients and physicians were unaware of the adherence assessment. This objective assessment of medication use showed that adherence is extremely poor when patients are unaware of monitoring.
Results of the study published in the journal Hypertension , report that, in 80 per cent of patients, fewer medications were detected than prescribed. Furthermore, adherence changed during follow-up in 31 per cent of participants. Changes in adherence over time may have considerable effects on treatment estimates.
Meanwhile, the study authors concluded that RDN is not superior to usual care in reducing blood pressure in patients with resistant hypertension. Primary analyses found a mean difference in daytime systolic BP of 2.0mmHg between RDN and control in favour of control.