Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Medication adherence and resistant hypertension

Journal of Human Hypertension volume 29, pages 213–218 (2015)Cite this article

Subjects

Abstract

Non-adherence has been a major concern in the treatment of hypertension and is particularly important in understanding and intervening in patients who appear to have resistant hypertension. Relatively few studies have examined the role of non-adherence in resistant hypertension. This review will address issues related to measurement of adherence, adherence interventions and rates of non-adherence in general hypertensive populations and in patients classified as having resistant hypertension.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Calhoun DA, White WB . Effectiveness of the selective aldosterone blocker, eplerenone, in patients with resistant hypertension. J Am Soc Hypertens 2008; 2 (6): 462–468.

    Article  Google Scholar 

  2. Judd E, Calhoun DA . Apparent and true resistant hypertension: definition, prevalence and outcomes. J Hum Hypertens 2014; 28 (8): 463–468.

    Article  CAS  Google Scholar 

  3. Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J . Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension 2013; 62 (2): 218–225.

    Article  CAS  Google Scholar 

  4. Shi L, Liu J, Koleva Y, Fonseca V, Kalsekar A, Pawaskar M et al. Concordance of adherence measurement using self-reported adherence questionnaires and medication monitoring devices. Pharmacoeconomics 2010; 28 (12): 1097–1107.

    Article  Google Scholar 

  5. Zeller A, Ramseier E, Teagtmeyer A, Battegay E . Patients' self-reported adherence to cardiovascular medication using electronic monitors as comparators. Hypertens Res 2008; 31 (11): 2037–2043.

    Article  Google Scholar 

  6. Sackett DL, Haynes RB, Gibson ES, Hackett BC, Taylor DW, Roberts RS et al. Randomised clinical trial of strategies for improving medication compliance in primary hypertension. Lancet 1975; 1 (7918): 1205–1207.

    Article  CAS  Google Scholar 

  7. Steiner JF, Earnest MA . The language of medication-taking. Ann Intern Med 2000; 132 (11): 926–930.

    Article  CAS  Google Scholar 

  8. Karve S, Cleves MA, Helm M, Hudson TJ, West DS, Martin BC et al. Good and poor adherence: optimal cut-point for adherence measures using administrative claims data. Curr Med Res Opin 2009; 25 (9) 2303–2310.

    Article  Google Scholar 

  9. Fitzgerald AA, Powers JD, Ho PM, Maddox TM, Peterson PN, Allen LA et al. Impact of medication nonadherence on hospitalizations and mortality in heart failure. J Card Fail 2011; 17 (8): 664–669.

    Article  Google Scholar 

  10. Oleen-Burkey MA, Dor A, Castelli-Haley J, Lage MJ . The relationship between alternative medication possession ratio thresholds and outcomes: evidence from the use of glatiramer acetate. J Med Econ 2011; 14 (6): 739–747.

    Article  CAS  Google Scholar 

  11. Watanabe JH, Bounthavong M, Chen T . Revisiting the medication possession ratio threshold for adherence in lipid management. Curr Med Res Opin 2013; 29 (3): 175–180.

    Article  CAS  Google Scholar 

  12. Curtis JR, Larson JC, Delzell E, Brookhart MA, Cadarette SM, Chlebowski R et al. Placebo adherence, clinical outcomes, and mortality in the women's health initiative randomized hormone therapy trials. Med Care 2011; 49 (5): 427–435.

    Article  Google Scholar 

  13. Lowy A, Munk VC, Ong SH, Burnier M, Vrijens B, Tousset EP et al. Effects on blood pressure and cardiovascular risk of variations in patients' adherence to prescribed antihypertensive drugs: role of duration of drug action. Int J Clin Pract 2011; 65 (1): 41–53.

    Article  CAS  Google Scholar 

  14. Chobanian AV . Impact of nonadherence to antihypertensive therapy. Circulation 2009; 120 (16): 1558–1560.

    Article  Google Scholar 

  15. Hill MN, Miller NH, Degeest S, Materson BJ, Black HR, Izzo JL Jr et al. Adherence and persistence with taking medication to control high blood pressure. J Am Soc Hypertens 2011; 5 (1): 56–63.

    Article  Google Scholar 

  16. Mathes T, Pieper D, Antoine SL, Eikermann M . 50% adherence of patients suffering chronic conditions–where is the evidence? Ger Med Sci 2012; 10, Doc16.

    PubMed  PubMed Central  Google Scholar 

  17. Hyman DJ, Pavlik VN . Poor hypertension control: let's stop blaming the patients. Cleve Clin J Med 2002; 69 (10): 793–799.

    Article  Google Scholar 

  18. Moser M, Franklin SS . Hypertension management: results of a new national survey for the hypertension education foundation: Harris interactive. J Clin Hypertens (Greenwich) 2007; 9 (5): 316–323.

    Article  Google Scholar 

  19. Bramley TJ, Gerbino PP, Nightengale BS, Frech-Tamas F . Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations. J Manag Care Pharm 2006; 12 (3): 239–245.

    PubMed  Google Scholar 

  20. Siegel D, Lopez J, Meier J . Antihypertensive medication adherence in the Department of Veterans Affairs. Am J Med 2007; 120 (1): 26–32.

    Article  Google Scholar 

  21. Ndumele CD, Shaykevich S, Williams D, Hicks LS . Disparities in adherence to hypertensive care in urban ambulatory settings. J Health Care Poor Underserved 2010; 21 (1): 132–143.

    Article  Google Scholar 

  22. Bosworth HB, Dudley T, Olsen MK, Voils CI, Powers B, Goldstein MK et al. Racial differences in blood pressure control: potential explanatory factors. Am J Med 2006; 119 (1): 70 e9-15.

    Article  Google Scholar 

  23. Eze-Nliam CM, Thombs BD, Lima BB, Smith CG, Ziegelstein RC . The association of depression with adherence to antihypertensive medications: a systematic review. J Hypertens 2010; 28 (9): 1785–1795.

    Article  CAS  Google Scholar 

  24. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X . Interventions for enhancing medication adherence. Cochrane Database Syst Rev 2008; 16 (2): CD000011.

    Google Scholar 

  25. Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med 2012; 157 (11): 785–795.

    Article  Google Scholar 

  26. Gwadry-Sridhar FH, Manias E, Lal L, Salas M, Hughes DA, Ratzki-Leewing A et al. Impact of interventions on medication adherence and blood pressure control in patients with essential hypertension: a systematic review by the ISPOR medication adherence and persistence special interest group. Value Health 2013; 16 (5): 863–871.

    Article  Google Scholar 

  27. Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Bohm M et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010; 376(9756): 1903–1909.

  28. Worthley SG1 TC, Worthley MI, Sinhal A, Chew DP, Meredith IT, Malaiapan Y et al. Safety and efficacy of a multi-electrode renal sympathetic denervation system in resistant hypertension: the EnligHTN I trial. Eur Heart J 2013; 34, 2132–2140.

    Article  Google Scholar 

  29. Kandzari DE, Bhatt DL, Sobotka PA, O'Neill WW, Esler M, Flack JM et al. Catheter-based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN-3 Trial. Clin Cardiol 2012; 35 (9): 528–535.

    Article  Google Scholar 

  30. Fadl Elmula FE, Hoffmann P, Fossum E, Brekke M, Gjonnaess E, Hjornholm U et al. Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure. Hypertension 2013; 62 (3): 526–532.

    Article  CAS  Google Scholar 

  31. Yakovlevitch M, Black HR . Resistant hypertension in a tertiary care clinic. Arch Intern Med 1991; 151 (9): 1786–1792.

    Article  CAS  Google Scholar 

  32. Garg JP, Elliott WJ, Folker A, Izhar M, Black HR . Resistant hypertension revisited: a comparison of two university-based cohorts. Am J Hypertens 2005; 18 (5 Pt 1): 619–626.

    Article  Google Scholar 

  33. de Souza WA, Sabha M, de Faveri Favero F, Bergsten-Mendes G, Yugar-Toledo JC, Moreno H et al. Intensive monitoring of adherence to treatment helps to identify ‘true’ resistant hypertension. J Clin Hypertens (Greenwich) 2009; 11 (4): 183–191.

    Article  Google Scholar 

  34. Ceral J, Habrdova V, Vorisek V, Bima M, Pelouch R, Solar M et al. Difficult-to-control arterial hypertension or uncooperative patients? The assessment of serum antihypertensive drug levels to differentiate non-responsiveness from non-adherence to recommended therapy. Hypertens Res 2011; 34 (1): 87–90.

    Article  CAS  Google Scholar 

  35. Jung O, Gechter JL, Wunder C, Paulke A, Bartel C, Geiger H et al. Resistant hypertension? Assessment of adherence by toxicological urine analysis. J Hypertens 2013; 31 (4): 766–774.

    Article  CAS  Google Scholar 

  36. Brinker S, Pandey A, Ayers C, Price A, Raheja P, Arbique D et al. Therapeutic drug monitoring facilitates blood pressure control in resistant hypertension. J Am Coll Cardiol 2014; 63 (8): 834–835.

    Article  Google Scholar 

  37. Pandey A, Brinker S, Ayers C, Arbique D, Price A, Das S et al Comparison of Morisky Medication Adherence Scale with Therapeutic drug monitoring in resistant hypertension. J Clin Hypertens 2013; 15: 1.

    Google Scholar 

  38. Bunker J, Callister W, Chang CL, Sever PS . How common is true resistant hypertension? J Hum Hypertens 2011; 25 (2): 137–140.

    Article  CAS  Google Scholar 

  39. Grassi D, O'Flaherty M, Pellizzari M, Bendersky M, Rodriguez P, Turri D et al. Hypertensive urgencies in the emergency department: evaluating blood pressure response to rest and to antihypertensive drugs with different profiles. J Clin Hypertens (Greenwich) 2008; 10 (9): 662–667.

    Article  Google Scholar 

  40. Untreated mild hypertension. A report by the Management Committee of the Australian Therapeutic Trial in Mild Hypertension. Lancet 1982; 1 (8265): 185–191.

    Google Scholar 

  41. Bunker J, Callister W, Chang C-L, Sever PS . How common is true resistant hypertension?. J Hum Hypertens 2011; 25: 137–140.

    Article  CAS  Google Scholar 

  42. Ruzicka M, McCormick B, Leenen FH, Froeschl M, Hiremath S . Adherence to blood pressure-lowering drugs and resistant hypertension: should trial of direct observation therapy be part of preassessment for renal denervation? Can J Cardiol 2013; 29 (12): 1741 e1-3.

    Article  Google Scholar 

  43. Rose AJ, Berlowitz DR, Manze M, Orner MB, Kressin NR . Intensifying therapy for hypertension despite suboptimal adherence. Hypertension 2009; 54 (3): 524–529.

    Article  CAS  Google Scholar 

  44. Burnier M, Schneider MP, Chiolero A, Stubi CL, Brunner HR . Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions. J Hypertens 2001; 19 (2): 335–341.

    Article  CAS  Google Scholar 

  45. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation 2012; 125 (13): 1635–1642.

    Article  Google Scholar 

  46. Daugherty SL, Powers JD, Magid DJ, Masoudi FA, Margolis KL, O'Connor PJ et al. The association between medication adherence and treatment intensification with blood pressure control in resistant hypertension. Hypertension 2012; 60 (2): 303–309.

    Article  CAS  Google Scholar 

  47. Sim JJ, Bhandari SK, Shi J, Liu IL, Calhoun DA, McGlynn EA et al. Characteristics of resistant hypertension in a large, ethnically diverse hypertension population of an integrated health system. Mayo Clin Proc 2013; 88 (10): 1099–1107.

    Article  Google Scholar 

  48. Sim JJ, Shi J, Kristi R, Elizabeth M, David C, Kamyar K-Z et al. Longititudinal evaluation of medication adherence among a resistant hypertension population. J Clin Hypertens 2013; 15 (1) A92.

    Google Scholar 

  49. Irvin MR, Shimbo D, Mann DM, Reynolds K, Krousel-Wood M, Limdi NA et al. Prevalence and correlates of low medication adherence in apparent treatment-resistant hypertension. J Clin Hypertens (Greenwich) 2012; 14 (10): 694–700.

    Article  Google Scholar 

  50. Grigoryan L, Pavlik VN, Hyman DJ . Characteristics, drug combinations and dosages of primary care patients with uncontrolled ambulatory blood pressure and high medication adherence. J Am Soc Hypertens 2013; 7 (6): 471–476.

    Article  CAS  Google Scholar 

  51. de Oliveira-Filho AD, Costa FA, Neves SJ, de Lyra Junior DP, Morisky DE . Pseudoresistant hypertension due to poor medication adherence. Int J Cardiol 2014; 172 (2): e309–e310.

    Article  Google Scholar 

  52. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311 (5): 507–520.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Kim Dillman for manuscript preparation.

Author information

Authors and Affiliations

  1. Section of General Internal Medicine, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA

    D J Hyman & V Pavlik

Authors
  1. D J Hyman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V Pavlik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D J Hyman.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hyman, D., Pavlik, V. Medication adherence and resistant hypertension. J Hum Hypertens 29, 213–218 (2015). https://doi.org/10.1038/jhh.2014.73

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2014.73

This article is cited by

Search

Advanced search

Quick links