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2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018; 36:1953-2041. [PMID: 30234752 DOI: 10.1097/hjh.0000000000001940] [Citation(s) in RCA: 1809] [Impact Index Per Article: 301.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
: Document reviewers: Guy De Backer (ESC Review Co-ordinator) (Belgium), Anthony M. Heagerty (ESH Review Co-ordinator) (UK), Stefan Agewall (Norway), Murielle Bochud (Switzerland), Claudio Borghi (Italy), Pierre Boutouyrie (France), Jana Brguljan (Slovenia), Héctor Bueno (Spain), Enrico G. Caiani (Italy), Bo Carlberg (Sweden), Neil Chapman (UK), Renata Cifkova (Czech Republic), John G. F. Cleland (UK), Jean-Philippe Collet (France), Ioan Mircea Coman (Romania), Peter W. de Leeuw (The Netherlands), Victoria Delgado (The Netherlands), Paul Dendale (Belgium), Hans-Christoph Diener (Germany), Maria Dorobantu (Romania), Robert Fagard (Belgium), Csaba Farsang (Hungary), Marc Ferrini (France), Ian M. Graham (Ireland), Guido Grassi (Italy), Hermann Haller (Germany), F. D. Richard Hobbs (UK), Bojan Jelakovic (Croatia), Catriona Jennings (UK), Hugo A. Katus (Germany), Abraham A. Kroon (The Netherlands), Christophe Leclercq (France), Dragan Lovic (Serbia), Empar Lurbe (Spain), Athanasios J. Manolis (Greece), Theresa A. McDonagh (UK), Franz Messerli (Switzerland), Maria Lorenza Muiesan (Italy), Uwe Nixdorff (Germany), Michael Hecht Olsen (Denmark), Gianfranco Parati (Italy), Joep Perk (Sweden), Massimo Francesco Piepoli (Italy), Jorge Polonia (Portugal), Piotr Ponikowski (Poland), Dimitrios J. Richter (Greece), Stefano F. Rimoldi (Switzerland), Marco Roffi (Switzerland), Naveed Sattar (UK), Petar M. Seferovic (Serbia), Iain A. Simpson (UK), Miguel Sousa-Uva (Portugal), Alice V. Stanton (Ireland), Philippe van de Borne (Belgium), Panos Vardas (Greece), Massimo Volpe (Italy), Sven Wassmann (Germany), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain).The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.
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Postel-Vinay N, Reach G, Eveillard P. Observance et nouvelles technologies : nouveau regard sur une problématique ancienne. Med Sci (Paris) 2018; 34:723-729. [DOI: 10.1051/medsci/20183408020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
En médecine, l’un des intérêts des nouvelles techniques de l’information et de la communication réside dans l’efficacité et la sécurité des traitements, sans méconnaître le fait que tous les patients ne pourront pas bénéficier de ces techniques, faute de pouvoir les maîtriser.
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Courand PY, Azizi M, Lantelme P. Renal denervation in hypertension: Towards a true revival? Arch Cardiovasc Dis 2018; 111:541-544. [PMID: 30219622 DOI: 10.1016/j.acvd.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 08/17/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Pierre-Yves Courand
- Cardiology Department, European Society of Hypertension Excellence Centre, hôpital de la Croix-Rousse et hôpital Lyon Sud, hospices civils de Lyon, 69004 Lyon, France; CREATIS, CNRS UMR 5220, INSERM U1044, INSA-Lyon, université Claude-Bernard Lyon 1, hospices civils de Lyon, 69100 Lyon, France.
| | - Michel Azizi
- Université Paris-Descartes, 75006 Paris, France; Hypertension Department, hôpital européen Georges-Pompidou, AP-HP, 75908 Paris, France; INSERM CIC 1418, 75908 Paris, France
| | - Pierre Lantelme
- Cardiology Department, European Society of Hypertension Excellence Centre, hôpital de la Croix-Rousse et hôpital Lyon Sud, hospices civils de Lyon, 69004 Lyon, France; CREATIS, CNRS UMR 5220, INSERM U1044, INSA-Lyon, université Claude-Bernard Lyon 1, hospices civils de Lyon, 69100 Lyon, France
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Mahfoud F, Schlaich M, Böhm M, Esler M, Lüscher TF. Catheter-based renal denervation: the next chapter begins. Eur Heart J 2018; 39:4144-4149. [DOI: 10.1093/eurheartj/ehy584] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Felix Mahfoud
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Straße, Geb. 40, Homburg, Saar, Germany
- Institute for Medical Engineering and Science, MIT, Cambridge, MA, USA
| | - Markus Schlaich
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western, Perth, Australia
- Department of Cardiology, Royal Perth Hospital, Perth, Australia
- Department of Nephrology, Royal Perth Hospital, Perth, Australia
- Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Michael Böhm
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Straße, Geb. 40, Homburg, Saar, Germany
| | - Murray Esler
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Thomas Felix Lüscher
- Royal Brompton & Harefield Hospitals and Imperial College, Cardiology, London, UK
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
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A simple UHPLC-PDA method with a fast dilute-and-shot sample preparation for the quantification of canrenone and its prodrug spironolactone in human urine samples. J Pharmacol Toxicol Methods 2018; 94:29-35. [PMID: 30165207 DOI: 10.1016/j.vascn.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/03/2018] [Accepted: 08/22/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Nowadays, the treatment of hypertension represents an important issue, particularly in developed countries. While in most cases the standard therapeutic approaches, consisting in the administration of 1 to 3 drugs, are adequate to reach adequate blood pressure levels, in some cases more drugs are needed: this condition is called "resistant hypertension". In this context, the administration of a diuretic, such as spironolactone or canrenoate salts, represents a standard practice. Since a reliable discrimination of real cases of resistant hypertension from cases of poor therapeutic adherence is currently difficult to obtain, the adoption of therapeutic drug monitoring has been suggested as a useful tool for this purpose. In this work, the authors developed and validated a simple, cheap and fast dilute-and-shot method with UHPLC-PDA analysis for the quantification of spironolactone and its metabolite canrenone in human urine samples. METHODS Standards and quality controls were prepared in urine. Only 100 μL of sample were added with 80 μL of internal standard (6,7-dimethyl-2,3-di(2-pyridyl)quinoxaline) working solution and 820 μL of phosphate buffer 10 mM pH 3.2 (phase A):acetonitrile (phase B) 90:10 v:v solution. Chromatographic separation was performed on an Acquity® UPLC HSS T3 1.8 μm 2.1 × 150 mm column, with a binary gradient for 11 min at 40 °C. RESULTS Accuracy, intra-day and inter-day precision, selectivity and sensitivity fitted FDA guidelines for all analytes (LLOQ and LOD were 156.25 ng/mL and 78.12 ng/mL, respectively, for both analytes) and recovery resulted high and reproducible. Method performances were tested on urine samples from hypertensive patients with good results. DISCUSSION This simple analytical method could represent a useful tool for the management of antihypertensive therapy.
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Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39:3021-3104. [PMID: 30165516 DOI: 10.1093/eurheartj/ehy339] [Citation(s) in RCA: 5688] [Impact Index Per Article: 948.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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107
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Avataneo V, De Nicolò A, Rabbia F, Perlo E, Burrello J, Berra E, Pappaccogli M, Cusato J, D'Avolio A, Di Perri G, Veglio F. Therapeutic drug monitoring-guided definition of adherence profiles in resistant hypertension and identification of predictors of poor adherence. Br J Clin Pharmacol 2018; 84:2535-2543. [PMID: 29971815 DOI: 10.1111/bcp.13706] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/01/2018] [Accepted: 06/23/2018] [Indexed: 12/11/2022] Open
Abstract
AIMS Arterial hypertension is an important cardiovascular risk factor. A substantial proportion of patients show resistance to antihypertensive treatment but poor adherence to medication regimens is also a significant cause of treatment failure. In this context, therapeutic drug monitoring (TDM) could be useful. The objective of this study was to assess adherence to treatment in patients with resistant hypertension by TDM and to identify parameters that predict nonadherence. METHODS Liquid chromatography tandem mass spectrometry was used to quantify a wide panel of antihypertensive drugs in human plasma to assess treatment compliance. Associations between TDM-determined adherence profiles, self-reported adherence and other patient-related clinical, anthropometric or demographic features were evaluated as potentially useful pre-TDM predictors of poor adherence. RESULTS TDM was performed on 50 patients with suspected resistant hypertension: 24% of patients partially complied to treatment and 18% were nonadherent. No concordance was observed with questionnaire results, while nonadherence was associated with high diastolic blood pressure, high heart rate, previous onset of stroke and previous use of invasive treatments, including renal denervation or baroreceptor stimulation. CONCLUSIONS This evidence highlights the high prevalence of poor adherence in patients with resistant hypertension and the need for caution in using invasive approaches. These preliminary data require validation in a larger cohort, to confirm the need for TDM in routine clinical practice.
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Affiliation(s)
- Valeria Avataneo
- Laboratory of Clinical Pharmacology and Pharmacogenetics#, University of Turin, Turin, Italy.,Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Amedeo De Nicolò
- Laboratory of Clinical Pharmacology and Pharmacogenetics#, University of Turin, Turin, Italy.,Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Franco Rabbia
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elisa Perlo
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Jacopo Burrello
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elena Berra
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Marco Pappaccogli
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics#, University of Turin, Turin, Italy.,Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics#, University of Turin, Turin, Italy.,Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Giovanni Di Perri
- Laboratory of Clinical Pharmacology and Pharmacogenetics#, University of Turin, Turin, Italy.,Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Franco Veglio
- Division of Internal Medicine and Hypertension Unit, University of Turin, Turin, Italy.,Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
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108
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The Use of Dried Blood Spots for the Quantification of Antihypertensive Drugs. Int J Anal Chem 2018; 2018:3235072. [PMID: 30154849 PMCID: PMC6093062 DOI: 10.1155/2018/3235072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/09/2018] [Accepted: 07/02/2018] [Indexed: 12/16/2022] Open
Abstract
Hypertension or high blood pressure is a harbinger of cardiovascular diseases. There are several classes of drugs used to treat hypertension. This review discusses the use of dried blood spots (DBSs) for the quantification by mass spectrometry (MS), tandem mass spectrometry (MS/MS), or, in some cases, by fluorescence detection methods the following antihypertensive medications: angiotensin-converting enzyme inhibitors (ramipril, ramiprilat, captopril, and lisinopril); angiotensin II receptor antagonists (valsartan, irbesartan, losartan, and losartan carboxylic acid); calcium channel blockers (verapamil, amlodipine, nifedipine, pregabalin, and diltiazem); α blockers (guanfacine, doxazosin, and prazosin); β blockers (propranolol, bisoprolol, atenolol, and metoprolol); endothelin receptor antagonists (bosentan and ambrisentan); and statins (simvastatin, atorvastatin, and rosuvastatin).
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Petit G, Berra E, Georges CM, Capron A, Huang QF, Lopez-Sublet M, Rabbia F, Staessen JA, Wallemacq P, de Timary P, Persu A. Impact of psychological profile on drug adherence and drug resistance in patients with apparently treatment-resistant hypertension. Blood Press 2018; 27:358-367. [DOI: 10.1080/08037051.2018.1476058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Géraldine Petit
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Elena Berra
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Coralie M.G. Georges
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Arnaud Capron
- Clinical Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Center for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium
| | - Qi-Fang Huang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Belgium
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Marilucy Lopez-Sublet
- Department of Internal Medicine and Arterial Hypertension, Avicenne University Hospital, Bobigny Cedex, France
| | - Franco Rabbia
- Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Pierre Wallemacq
- Clinical Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Center for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Alexandre Persu
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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110
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Hypertension: history and development of established and novel treatments. Clin Res Cardiol 2018; 107:16-29. [DOI: 10.1007/s00392-018-1299-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/11/2018] [Indexed: 01/08/2023]
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111
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Kandzari DE, Böhm M, Mahfoud F, Townsend RR, Weber MA, Pocock S, Tsioufis K, Tousoulis D, Choi JW, East C, Brar S, Cohen SA, Fahy M, Pilcher G, Kario K. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet 2018; 391:2346-2355. [PMID: 29803589 DOI: 10.1016/s0140-6736(18)30951-6] [Citation(s) in RCA: 510] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous catheter-based renal denervation studies have reported variable efficacy results. We aimed to evaluate safety and blood pressure response after renal denervation or sham control in patients with uncontrolled hypertension on antihypertensive medications with drug adherence testing. METHODS In this international, randomised, single-blind, sham-control, proof-of-concept trial, patients with uncontrolled hypertension (aged 20-80 years) were enrolled at 25 centres in the USA, Germany, Japan, UK, Australia, Austria, and Greece. Eligible patients had an office systolic blood pressure of between 150 mm Hg and 180 mm Hg and a diastolic blood pressure of 90 mm Hg or higher; a 24 h ambulatory systolic blood pressure of between 140 mm Hg and 170 mm Hg at second screening; and were on one to three antihypertensive drugs with stable doses for at least 6 weeks. Patients underwent renal angiography and were randomly assigned to undergo renal denervation or sham control. Patients, caregivers, and those assessing blood pressure were masked to randomisation assignments. The primary efficacy endpoint was blood pressure change from baseline (measured at screening visit two), based on ambulatory blood pressure measurements assessed at 6 months, as compared between treatment groups. Drug surveillance was used to assess medication adherence. The primary analysis was done in the intention-to-treat population. Safety events were assessed through 6 months as per major adverse events. This trial is registered with ClinicalTrials.gov, number NCT02439775, and follow-up is ongoing. FINDINGS Between July 22, 2015, and June 14, 2017, 467 patients were screened and enrolled. This analysis presents results for the first 80 patients randomly assigned to renal denervation (n=38) and sham control (n=42). Office and 24 h ambulatory blood pressure decreased significantly from baseline to 6 months in the renal denervation group (mean baseline-adjusted treatment differences in 24 h systolic blood pressure -7·0 mm Hg, 95% CI -12·0 to -2·1; p=0·0059, 24 h diastolic blood pressure -4·3 mm Hg, -7·8 to -0·8; p=0.0174, office systolic blood pressure -6·6 mm Hg, -12·4 to -0·9; p=0·0250, and office diastolic blood pressure -4·2 mm Hg, -7·7 to -0·7; p=0·0190). The change in blood pressure was significantly greater at 6 months in the renal denervation group than the sham-control group for office systolic blood pressure (difference -6·8 mm Hg, 95% CI -12·5 to -1·1; p=0·0205), 24 h systolic blood pressure (difference -7·4 mm Hg, -12·5 to -2·3; p=0·0051), office diastolic blood pressure (difference -3·5 mm Hg, -7·0 to -0·0; p=0·0478), and 24 h diastolic blood pressure (difference -4·1 mm Hg, -7·8 to -0·4; p=0·0292). Evaluation of hourly changes in 24 h systolic blood pressure and diastolic blood pressure showed blood pressure reduction throughout 24 h for the renal denervation group. 3 month blood pressure reductions were not significantly different between groups. Medication adherence was about 60% and varied for individual patients throughout the study. No major adverse events were recorded in either group. INTERPRETATION Renal denervation in the main renal arteries and branches significantly reduced blood pressure compared with sham control with no major safety events. Incomplete medication adherence was common. FUNDING Medtronic.
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Affiliation(s)
- David E Kandzari
- Department of Interventional Cardiology, Piedmont Heart Institute, Atlanta, GA, USA.
| | - Michael Böhm
- Department of Internal Medicine, Universitätsklinikum des Saarlandes, Saarland University, Homburg/Saar, Germany
| | - Felix Mahfoud
- Department of Internal Medicine, Universitätsklinikum des Saarlandes, Saarland University, Homburg/Saar, Germany; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Raymond R Townsend
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael A Weber
- Department of Medicine, SUNY Downstate College of Medicine, Brooklyn, NY, USA
| | - Stuart Pocock
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Konstantinos Tsioufis
- Department of Cardiology, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- Department of Cardiology, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - James W Choi
- Department of Cardiology, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, TX, USA
| | - Cara East
- Department of Cardiology, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, TX, USA
| | | | - Sidney A Cohen
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Medtronic PLC, Santa Rosa, CA, USA
| | | | | | - Kazuomi Kario
- Department of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018. [DOI: 10.1161/hyp.0000000000000065 10.1016/j.jacc.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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113
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Therapieresistente und -refraktäre arterielle Hypertonie. Internist (Berl) 2018; 59:567-579. [DOI: 10.1007/s00108-018-0430-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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114
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Wei FF, Zhang ZY, Huang QF, Staessen JA. Diagnosis and management of resistant hypertension: state of the art. Nat Rev Nephrol 2018; 14:428-441. [DOI: 10.1038/s41581-018-0006-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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115
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Medication adherence among patients with apparent treatment-resistant hypertension: systematic review and meta-analysis. J Hypertens 2018; 35:2346-2357. [PMID: 28777133 DOI: 10.1097/hjh.0000000000001502] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Medication nonadherence is a known behavioural contributor to poor blood pressure (BP) control that puts patients with hypertension at elevated cardiovascular risk. Studies of medication adherence for apparent treatment-resistant hypertension (aTRH) vary significantly with respect to design, methods, and setting, and, as a result, have produced highly variable figures describing the prevalence of nonadherence. This review aimed to describe the prevalence and potential moderators of medication nonadherence estimates for aTRH. METHODS Systematic review and random effects meta-analysis. RESULTS From an initial discovery of 921 studies, we identified 24 studies that measured medication adherence for patients with uncontrolled BP despite being prescribed three or more antihypertensive medications of different classes. By using a random effects model, the pooled prevalence of nonadherence was 31.2% (95% confidence interval = 20.2-44.7, I = 99.50) with nonadherence rates ranging from 3.3 to 86.1%. The strongest contributor to variance in nonadherence rates was the method of adherence assessment used. Studies that relied on self-report measures of adherence and/or pharmacy data reported lower levels of nonadherence than studies using more objective methods, such as liquid chromatography-mass spectrometry in single time-point bioassays or directly observed therapy. CONCLUSION Findings indicate that medication nonadherence is a significant problem among aTRH patients. Identifying the most accurate and clinically feasible adherence assessment methods is necessary to reduce BP and cardiovascular morbidity, facilitate early behavioural intervention, prevent unnecessary diagnostic testing, and limit sometimes unnecessary and expensive BP lowering procedures. REGISTRATION NUMBER CRD42016028121.
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McFarlane PA. Resistant Hypertension in Adults With Type 1 or 2 Diabetes: A Structured Diagnostic Approach. Can J Diabetes 2018; 42:173-178. [PMID: 29602405 DOI: 10.1016/j.jcjd.2018.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
Abstract
People with diabetes often have difficulty reaching their blood pressure targets and are labelled as having resistant hypertension. Clinicians often move quickly to screen such people for secondary causes of hypertension; however, such causes are rare, and resistant hypertension usually has other explanations that are significantly more common. By using a structured approach to resistant hypertension, clinicians can assist patients to reach their target blood pressure levels. Step 1 is to determine out-of-office blood pressure measurements using home or ambulatory blood pressure monitors. Step 2 is to determine the level of adherence to prescribed medications. Step 3 is to identify interfering substances. Step 4 is to check that the prescribed medications are synergistic and optimally dosed. Finally, if all other steps fail to get patients to their blood pressure targets, we consider possible secondary causes of hypertension. This approach is particularly useful in helping people with diabetes to reach their blood pressure targets.
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Affiliation(s)
- Philip A McFarlane
- Home Dialysis, Division of Nephrology, St. Michael's Hospital, Toronto, Ontario, Canada.
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Persu A, Petit G, Georges C, de Timary P. Hypertension, a Posttraumatic Stress Disorder? Time to Widen Our Perspective. Hypertension 2018; 71:811-812. [PMID: 29555667 DOI: 10.1161/hypertensionaha.118.10608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alexandre Persu
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium.
| | - Géraldine Petit
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
| | - Coralie Georges
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
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118
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Lackland DT, Carey RM, Conforto AB, Rosendorff C, Whelton PK, Gorelick PB. Implications of Recent Clinical Trials and Hypertension Guidelines on Stroke and Future Cerebrovascular Research. Stroke 2018; 49:772-779. [PMID: 29467237 PMCID: PMC5829017 DOI: 10.1161/strokeaha.117.019379] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/08/2017] [Accepted: 01/11/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Daniel T Lackland
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.).
| | - Robert M Carey
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.)
| | - Adriana B Conforto
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.)
| | - Clive Rosendorff
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.)
| | - Paul K Whelton
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.)
| | - Philip B Gorelick
- From the Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.); Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.); Department of Neurology, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (A.B.C.); Department of Medicine (Cardiology), Mount Sinai Heart and the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (C.R.); James J. Peters VA Medical Center, Bronx, NY (C.R.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (P.K.W.); and Division of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine and Mercy Health Hauenstein Neurosciences, Grand Rapids (P.B.G.)
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Nashilongo MM, Singu B, Kalemeera F, Mubita M, Naikaku E, Baker A, Ferrario A, Godman B, Achieng L, Kibuule D. Assessing Adherence to Antihypertensive Therapy in Primary Health Care in Namibia: Findings and Implications. Cardiovasc Drugs Ther 2017; 31:565-578. [PMID: 29032396 PMCID: PMC5730630 DOI: 10.1007/s10557-017-6756-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Namibia has the highest burden and incidence of hypertension in sub-Sahara Africa. Though non-adherence to antihypertensive therapy is an important cardiovascular risk factor, little is known about potential ways to improve adherence in Namibia following universal access. The objective of this study is to validate the Hill-Bone compliance scale and determine the level and predictors of adherence to antihypertensive treatment in primary health care settings in sub-urban townships of Windhoek, Namibia. METHODS Reliability was determined by Cronbach's alpha. Principal component analysis (PCA) was used to assess construct validity. RESULTS The PCA was consistent with the three constructs for 12 items, explaining 24.1, 16.7 and 10.8% of the variance. Cronbach's alpha was 0.695. None of the 120 patients had perfect adherence to antihypertensive therapy, and less than half had acceptable levels of adherence (≥ 80%). The mean adherence level was 76.7 ± 8.1%. Three quarters of patients ever missed their scheduled clinic appointment. Having a family support system (OR = 5.4, 95% CI 1.687-27.6, p = 0.045) and attendance of follow-up visits (OR = 3.1, 95% CI 1.1-8.7, p = 0.03) were significant predictors of adherence. Having HIV/AIDs did not lower adherence. CONCLUSIONS The modified Namibian version of the Hill-Bone scale is reliable and valid for assessing adherence to antihypertensives in Namibia. There is sub-optimal adherence to antihypertensive therapy among primary health cares in Namibia. This needs standardized systems to strengthen adherence monitoring as well as investigation of other factors including transport to take full advantage of universal access.
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Affiliation(s)
- M. M. Nashilongo
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
| | - B. Singu
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
| | - F. Kalemeera
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
| | - M. Mubita
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
| | - E. Naikaku
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
| | - A. Baker
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - A. Ferrario
- LSE Health, London School of Economics and Political Science, London, UK
| | - B. Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Health Economics Centre, Liverpool University Management School, Liverpool, UK
| | - L. Achieng
- Department of Medicine, University of Nairobi, Nairobi, Kenya
| | - D. Kibuule
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Box 13301, 340 Mandume Ndemufayo Avenue Pioneers Park, Windhoek, Namibia
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120
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Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017; 71:e13-e115. [PMID: 29133356 DOI: 10.1161/hyp.0000000000000065] [Citation(s) in RCA: 1577] [Impact Index Per Article: 225.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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121
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Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017; 71:e127-e248. [PMID: 29146535 DOI: 10.1016/j.jacc.2017.11.006] [Citation(s) in RCA: 3074] [Impact Index Per Article: 439.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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122
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Drug adherence in hypertension. Pharmacol Res 2017; 125:142-149. [DOI: 10.1016/j.phrs.2017.08.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 01/13/2023]
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123
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Burnier M, Narkiewicz K, Kjeldsen SE, Oparil S. Renal denervation in hypertension: is it the end or the beginning of a SPYRAL? Blood Press 2017; 26:319-320. [PMID: 28975817 DOI: 10.1080/08037051.2017.1386539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michel Burnier
- a Service of Nephrology and Hypertension , Centre Hospitalier Universitaire Vaudois , Lausanne , Switzerland
| | - Krzysztof Narkiewicz
- b Department of Hypertension and Diabetology , Medical University of Gdansk , Poland
| | - Sverre E Kjeldsen
- c Department of Cardiology , University of Oslo, Ullevaal Hospital , Oslo , Norway
| | - Suzanne Oparil
- d Vascular Biology and Hypertension Program, Department of Medicine , University of Alabama at Birmingham , AL , USA
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124
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Routine urinary detection of antihypertensive drugs for systematic evaluation of adherence to treatment in hypertensive patients. J Hypertens 2017; 35:1891-1898. [DOI: 10.1097/hjh.0000000000001402] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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125
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McNaughton CD, Brown NJ, Rothman RL, Liu D, Kabagambe EK, Levy PD, Self WH, Storrow AB, Collins SP, Roumie CL. Systolic Blood Pressure and Biochemical Assessment of Adherence: A Cross-Sectional Analysis in the Emergency Department. Hypertension 2017; 70:307-314. [PMID: 28652467 PMCID: PMC5531074 DOI: 10.1161/hypertensionaha.117.09659] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 04/16/2017] [Accepted: 05/20/2017] [Indexed: 12/23/2022]
Abstract
Elevated blood pressure (BP) is common in the emergency department (ED), but the relationship between antihypertensive medication adherence and BP in the ED is unclear. This cross-sectional study tested the hypothesis that higher antihypertensive adherence is associated with lower systolic BP (SBP) in the ED among adults with hypertension who sought ED care at an academic hospital from July 2012 to April 2013. Biochemical assessment of antihypertensive adherence was performed using a mass spectrometry blood assay, and the primary outcome was average ED SBP. Analyses were stratified by number of prescribed antihypertensives (<3, ≥3) and adjusted for age, sex, race, insurance, literacy, numeracy, education, body mass index, and comorbidities. Among 85 patients prescribed ≥3 antihypertensives, mean SBP for adherent patients was 134.4 mm Hg (±26.1 mm Hg), and in adjusted analysis was -20.8 mm Hg (95% confidence interval, -34.2 to -7.4 mm Hg; P=0.003) different from nonadherent patients. Among 176 patients prescribed <3 antihypertensives, mean SBP was 135.5 mm Hg (±20.6 mm Hg) for adherent patients, with no difference by adherence in adjusted analysis (+2.9 mm Hg; 95% confidence interval, -4.7 to 10.5 mm Hg; P=0.45). Antihypertensive nonadherence identified by biochemical assessment was common and associated with higher SBP in the ED among patients who had a primary care provider and health insurance and who were prescribed ≥3 antihypertensives. Biochemical assessment of antihypertensives could help distinguish medication nonadherence from other contributors to elevated BP and identify target populations for intervention.
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Affiliation(s)
- Candace D McNaughton
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.).
| | - Nancy J Brown
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Russell L Rothman
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Dandan Liu
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Edmond K Kabagambe
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Phillip D Levy
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Wesley H Self
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Alan B Storrow
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Sean P Collins
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
| | - Christianne L Roumie
- From the Department of Emergency Medicine (C.D.M., W.H.S., A.B.S., S.P.C.), Department of Internal Medicine (N.J.B., R.L.R., C.L.R.), Department of Pediatrics (R.L.R., C.L.R.), Department of Biostatistics (D.L.), and Division of Epidemiology, Department of Medicine (E.K.K.), VUMC, Nashville, TN; Department of Emergency Medicine, Wayne State University, Detroit, MI (P.D.L.); and Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville (C.L.R.)
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126
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Hamdidouche I, Jullien V, Laurent S, Azizi M. Detecting Nonadherence to Antihypertensive Treatment. Hypertension 2017; 70:257-258. [DOI: 10.1161/hypertensionaha.117.09739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Idir Hamdidouche
- From the Paris-Descartes University, France (V.J., M.A., S.L.); INSERM, CIC1418, Paris, France (I.H., M.A.); Department of Pharmacology (I.H., V.J., S.L.), Hypertension Unit (M.A.), and DHU-PARC (M.A.), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France; and INSERM UMRS970, Paris, France (V.J., S.L.)
| | - Vincent Jullien
- From the Paris-Descartes University, France (V.J., M.A., S.L.); INSERM, CIC1418, Paris, France (I.H., M.A.); Department of Pharmacology (I.H., V.J., S.L.), Hypertension Unit (M.A.), and DHU-PARC (M.A.), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France; and INSERM UMRS970, Paris, France (V.J., S.L.)
| | - Stéphane Laurent
- From the Paris-Descartes University, France (V.J., M.A., S.L.); INSERM, CIC1418, Paris, France (I.H., M.A.); Department of Pharmacology (I.H., V.J., S.L.), Hypertension Unit (M.A.), and DHU-PARC (M.A.), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France; and INSERM UMRS970, Paris, France (V.J., S.L.)
| | - Michel Azizi
- From the Paris-Descartes University, France (V.J., M.A., S.L.); INSERM, CIC1418, Paris, France (I.H., M.A.); Department of Pharmacology (I.H., V.J., S.L.), Hypertension Unit (M.A.), and DHU-PARC (M.A.), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France; and INSERM UMRS970, Paris, France (V.J., S.L.)
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127
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Interventions to improve adherence of antihypertensive medication in African-Americans. J Hypertens 2017; 35:1164-1165. [DOI: 10.1097/hjh.0000000000001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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128
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UHPLC-MS/MS method with sample dilution to test therapeutic adherence through quantification of ten antihypertensive drugs in urine samples. J Pharm Biomed Anal 2017; 142:279-285. [PMID: 28538203 DOI: 10.1016/j.jpba.2017.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/08/2017] [Indexed: 01/26/2023]
Abstract
Nowadays, hypertension represents an important health problem, particularly in developed countries. In some cases the standard therapeutic approaches are not able to reestablish the normal blood pressure values: this condition is called "resistant hypertension". However, a fraction of cases of resistant hypertension are actually due to poor adherence to the prescribed therapy. Therapeutic Drug Monitoring could represent a direct and useful tool to correctly identify non-compliant patients. Nevertheless, high throughput methods for the simultaneous monitoring of a wide panel of drugs in the same analysis are lacking and, furthermore, there is not a generally acknowledged "standard" matrix for this test (plasma or urine). In this work, we validated a UHPLC-MS/MS assay to quantify ten among the most used antihypertensive agents in urine samples, covering all the current classes: amlodipine, atenolol, clonidine, chlortalidone, doxazosin, hydrochlorothiazide, nifedipine, olmesartan, ramipril and telmisartan. Both standards and quality controls were prepared in urine matrix. Only 100μL of each sample were added with 40μL of internal standard and 860μL of water:acetonitrile 90:10, acidified with 0.05% formic acid. Chromatographic separation was performed on an Acquity® UPLC HSS T3 1.8μm 2.1×150mm column, with a gradient of water and acetonitrile, both added with 0.05% formic acid. Accuracy, intra-day and inter-day precision fitted FDA guidelines for all analytes, while matrix effects resulted reproducible among different urine lots. Method performances were tested on urine samples from hypertensive patients with good results. This simple analytical method could represent a useful tool for the management of antihypertensive therapy.
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129
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Jacobs L, Persu A, Huang QF, Lengelé JP, Thijs L, Hammer F, Yang WY, Zhang ZY, Renkin J, Sinnaeve P, Wei FF, Pasquet A, Fadl Elmula FEM, Carlier M, Elvan A, Wunder C, Kjeldsen SE, Toennes SW, Janssens S, Verhamme P, Staessen JA. Results of a randomized controlled pilot trial of intravascular renal denervation for management of treatment-resistant hypertension. Blood Press 2017; 26:321-331. [DOI: 10.1080/08037051.2017.1320939] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Qi-Fang Huang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jean-Philippe Lengelé
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Department of Nephrology, Grand Hôpital de Charleroi, Gilly, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Frank Hammer
- Division of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jean Renkin
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Peter Sinnaeve
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Agnès Pasquet
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | - Marc Carlier
- Department of Cardiology, Grand Hôpital de Charleroi, Gilly, Belgium
| | - Arif Elvan
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - Cora Wunder
- Department of Forensic Toxicology, Institute of Legal Medicine, University of Frankfurt, Frankfurt, Germany
| | - Sverre E. Kjeldsen
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Stefan W. Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, University of Frankfurt, Frankfurt, Germany
| | - Stefan Janssens
- Division of Cardiology, Department Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Division of Cardiology, Department Internal Medicine, University Hospitals Leuven, Leuven, Belgium
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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130
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Fadl Elmula FEM, Feng YM, Jacobs L, Larstorp AC, Kjeldsen SE, Persu A, Staessen JA. Sham or no sham control: that is the question in trials of renal denervation for resistant hypertension. A systematic meta-analysis. Blood Press 2017; 26:195-203. [DOI: 10.1080/08037051.2017.1311769] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Fadl Elmula M. Fadl Elmula
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ying-Mei Feng
- Beijing Key Laboratory of Diabetes Prevention and Research, Department of Endocrinology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Anne C. Larstorp
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
| | - Sverre E. Kjeldsen
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Alexandre Persu
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Bruxelles, Begium
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R & D Vitak Group, Maastricht University, Maastricht, The Netherlands
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132
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Mariampillai JE, Eskås PA, Heimark S, Larstorp ACK, Fadl Elmula FEM, Høieggen A, Nortvedt P. Apparent treatment-resistant hypertension – patient–physician relationship and ethical issues. Blood Press 2017; 26:133-138. [DOI: 10.1080/08037051.2016.1277129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - Anne Cecilie K. Larstorp
- Department of Medical Biochemistry, Oslo University Hospital, Ullevaal, Oslo, Norway
- Section of Cardiovascular and Renal Research, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Fadl Elmula M. Fadl Elmula
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Section of Cardiovascular and Renal Research, Oslo University Hospital, Ullevaal, Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Department of Internal Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Aud Høieggen
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Section of Cardiovascular and Renal Research, Oslo University Hospital, Ullevaal, Oslo, Norway
- Department of Nephrology, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Per Nortvedt
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Center for Medical Ethics, University of Oslo, Oslo, Norway
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133
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Gupta P, Patel P, Horne R, Buchanan H, Williams B, Tomaszewski M. How to Screen for Non-Adherence to Antihypertensive Therapy. Curr Hypertens Rep 2016; 18:89. [PMID: 27889904 PMCID: PMC5124437 DOI: 10.1007/s11906-016-0697-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The quality of assessment of non-adherence to treatment in hypertensive is poor. Within this review, we discuss the different methods used to assess adherence to blood-pressure-lowering medications in hypertension patients. Subjective reports such as physicians' perceptions are inaccurate, and questionnaires completed by patients tend to overreport adherence and show a low diagnostic specificity. Indirect objective methods such as pharmacy database records can be useful, but they are limited by the robustness of the recorded data. Electronic medication monitoring devices are accurate but usually track adherence to only a single medication and can be expensive. Overall, the fundamental issue with indirect objective measures is that they do not fully confirm ingestion of antihypertensive medications. Detection of antihypertensive medications in body fluids using liquid chromatography-tandem mass spectrometry is currently, in our view, the most robust and clinically useful method to assess non-adherence to blood-pressure-lowering treatment. It is particularly helpful in patients presenting with resistant, refractory or uncontrolled hypertension despite the optimal therapy. We recommend using this diagnostic strategy to detect non-adherence alongside a no-blame approach tailoring support to address the perceptions (e.g. beliefs about the illness and treatment) and practicalities (e.g. capability and resources) influencing motivation and ability to adhere.
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Affiliation(s)
- Pankaj Gupta
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals of Leicester NHS Trust, Leicester, UK
- National Institute of Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- British Heart Foundation Cardiovascular Research Centre, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Prashanth Patel
- Department of Metabolic Medicine and Chemical Pathology, University Hospitals of Leicester NHS Trust, Leicester, UK
- National Institute of Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- British Heart Foundation Cardiovascular Research Centre, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Robert Horne
- Department of Behavioral Medicine, School of Pharmacy, University College London, London, UK
| | - Heather Buchanan
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London, London, UK
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Division of Medicine, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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134
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Armario P, Blanch P. [Resistant or refractory arterial hypertension?]. HIPERTENSION Y RIESGO VASCULAR 2016; 34:1-3. [PMID: 27866877 DOI: 10.1016/j.hipert.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 11/18/2022]
Affiliation(s)
- P Armario
- Área Atención Integrada de Riesgo Vascular, Hospital de Sant Joan Despí Moisès Broggi, Hospital General Hospitalet, Consorci Sanitari Integral, Universitat de Barcelona, Barcelona, España; Servicio de Medicina Interna, Hospital de Sant Joan Despí Moisès Broggi, Hospital General Hospitalet, Consorci Sanitari Integral, Universitat de Barcelona, Barcelona, España.
| | - P Blanch
- Área Atención Integrada de Riesgo Vascular, Hospital de Sant Joan Despí Moisès Broggi, Hospital General Hospitalet, Consorci Sanitari Integral, Universitat de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital de Sant Joan Despí Moisès Broggi, Hospital General Hospitalet, Consorci Sanitari Integral, Universitat de Barcelona, Barcelona, España
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135
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Rosa J, Zelinka T, Petrák O, Štrauch B, Holaj R, Widimský J. Should All Patients with Resistant Hypertension Receive Spironolactone? Curr Hypertens Rep 2016; 18:81. [PMID: 27787836 DOI: 10.1007/s11906-016-0690-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Ján Rosa
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Cardiocenter, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Tomáš Zelinka
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ondřej Petrák
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Branislav Štrauch
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Robert Holaj
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Widimský
- 3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
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136
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Azizi M, Pereira H, Hamdidouche I, Gosse P, Monge M, Bobrie G, Delsart P, Mounier-Véhier C, Courand PY, Lantelme P, Denolle T, Dourmap-Collas C, Girerd X, Michel Halimi J, Zannad F, Ormezzano O, Vaïsse B, Herpin D, Ribstein J, Chamontin B, Mourad JJ, Ferrari E, Plouin PF, Jullien V, Sapoval M, Chatellier G, Amar L, Lorthioir A, Pagny JY, Claisse G, Midulla M, Dauphin R, Fauvel J, Rouvière O, Cremer A, Grenier N, Lebras Y, Trillaud H, Heautot J, Larralde A, Paillard F, Cluzel P, Rosenbaum D, Alison D, Claudon M, Popovic B, Rossignol P, Baguet J, Thony F, Bartoli J, Drouineau J, Sosner P, Tasu J, Velasco S, Vernhet-Kovacsik H, Bouhanick B, Rousseau H, Le Jeune S, Lopez-Sublet M, Bellmann L, Esnault V, Baguet J, Vernhet-Kovacsik H, Durand-Zaleski I, Beregi (chair) J, Lièvre M, Persu A. Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial. Circulation 2016; 134:847-57. [DOI: 10.1161/circulationaha.116.022922] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/29/2016] [Indexed: 12/20/2022]
Abstract
Background:
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure–lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control.
Methods:
One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients.
Results:
The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (
P
=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was –6.7 mm Hg (
P
=0.0461) in fully adherent and –7.8 mm Hg (
P
=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients.
Conclusions:
In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone.
Clinical Trial Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
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Affiliation(s)
- Michel Azizi
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Helena Pereira
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Idir Hamdidouche
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Philippe Gosse
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Matthieu Monge
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Guillaume Bobrie
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pascal Delsart
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Claire Mounier-Véhier
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre-Yves Courand
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre Lantelme
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Thierry Denolle
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Caroline Dourmap-Collas
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Xavier Girerd
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean Michel Halimi
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Faiez Zannad
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Olivier Ormezzano
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Bernard Vaïsse
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Daniel Herpin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean Ribstein
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Bernard Chamontin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean-Jacques Mourad
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Emile Ferrari
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre-François Plouin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Vincent Jullien
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Marc Sapoval
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Gilles Chatellier
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - L. Amar
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | - A. Lorthioir
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | - J.-Y. Pagny
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | | | | | - R. Dauphin
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - J.P. Fauvel
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - O. Rouvière
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - A. Cremer
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - N. Grenier
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - Y. Lebras
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - H. Trillaud
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - J.F. Heautot
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - A. Larralde
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - F. Paillard
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - P. Cluzel
- Hôpital de la Pitié Salpétrière, Paris (6/5)
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