Eligibility for Baroreflex Activation Therapy and medication adherence in patients with apparently resistant hypertension.
adherence
antihypertensive medication
baroreflex activation therapy
resistant hypertension
uncontrolled hypertension
Journal
Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
30
04
2021
received:
27
03
2021
accepted:
16
05
2021
pubmed:
9
6
2021
medline:
10
8
2021
entrez:
8
6
2021
Statut:
ppublish
Résumé
Uncontrolled hypertension is a main risk factor for cardiovascular morbidity. Baroreflex activation therapy (BAT) is an effective therapy option addressing true resistant hypertension. We evaluated patients' eligibility for BAT in a staged assessment as well as adherence to antihypertensive drug therapy. Therefore, we analyzed files of 345 patients, attending the hypertension clinic at University Medicine Göttingen. Additionally, gas chromatographic-mass spectrometric urine analyses of selected individuals were performed evaluating their adherence. Most common cause for a revoked BAT recommendation was blood pressure (BP) control by drug adjustment (54.2%). Second leading cause was presence of secondary hypertension (31.6%). Patients to whom BAT was recommended (59 (17.1%)) were significantly more often male (67.8% vs. 43.3%, P = .0063), had a higher body mass index (31.8 ± 5.8 vs. 30.0 ± 5.7 kg/m², P = .0436), a higher systolic office (168.7 ± 24.7 vs. 147.7 ± 24.1 mmHg, P < .0001), and 24h ambulatory BP (155.0 ± 14.6 vs. 144.4 ± 16.8 mmHg, P = .0031), took more antihypertensive drugs (5.8 ± 1.3 vs. 4.4 ± 1.4, P < .0001), and suffered more often from numerous concomitant diseases. Eventually, 27 (7.8%) received a BAT system. In the toxicological analysis of 75 patients, mean adherence was 75.1%. 16 patients (21.3%) showed non-adherence. Thus, only a small number of patients eventually received a BAT system, as treatable reasons for apparently resistant hypertension could be identified frequently. This study is-to our knowledge-the first report of a staged assessment of patients' suitability for BAT and underlines the need for a careful examination and indication. Non-adherence was proven to be a relevant issue concerning apparently resistant hypertension and therefore non-eligibility for interventional antihypertensive therapy.
Identifiants
pubmed: 34101968
doi: 10.1111/jch.14302
pmc: PMC8678808
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1363-1371Informations de copyright
© 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.
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