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True Resistant Hypertension Following Observed Drug Ingestion: A Systematic Evaluation

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Title: True Resistant Hypertension Following Observed Drug Ingestion: A Systematic Evaluation
Authors: Bunker, J
Chang, CL
Chapman, N
Poulter, N
Thom, S
Thornton-Jones, L
Sever, P
Item Type: Journal Article
Abstract: The authors investigated the role of poor drug adherence in treatment-resistant hypertension following observed drug ingestion in 102 patients. Median blood pressures (BPs) were 170/91 mm Hg at referral, 153/84 mm Hg prior to, and 142/79 mm Hg during a 4- to 6-hour period after drug ingestion. Median daytime ambulatory BP monitoring (ABPM) over the following 24 hours was 142/80 mm Hg. Median BP at a final follow-up clinic visit was 147/79 mm Hg. The cumulative number of patients achieving a goal of <140/90 mm Hg in clinic or <135/85 mm Hg mean on ABPM was 57 (56%), with a further nine (9%) controlled at the final follow-up clinic visit. Thus, 65% of patients achieved a systolic BP <140 mm Hg at any point immediately prior to, or after, drug ingestion; the residual 35% were considered to have true resistant hypertension. In conclusion, among patients with suspected resistant hypertension, a minority were truly treatment-resistant following observed drug ingestion and BP monitoring.
Issue Date: 20-Aug-2016
Date of Acceptance: 23-Jul-2016
URI: http://hdl.handle.net/10044/1/50873
DOI: https://dx.doi.org/10.1111/jch.12896
ISSN: 1751-7176
Publisher: Wiley
Start Page: 250
End Page: 255
Journal / Book Title: Journal of Clinical Hypertension
Volume: 19
Issue: 3
Copyright Statement: This is the peer reviewed version of the following article: J Clin Hypertens (Greenwich). 2017;19:250–255. 10.1111/jch.12896 © 2016 Wiley Periodicals, Inc., which has been published in final form at https://dx.doi.org/10.1111/jch.12896.  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Funder's Grant Number: NF-SI-0510-10055
RDC02 79560
NF-SI-0513-10059
Keywords: Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
RENAL DENERVATION
CONTROLLED-TRIAL
BLOOD-PRESSURE
SPIRONOLACTONE
STATEMENT
1101 Medical Biochemistry And Metabolomics
1102 Cardiovascular Medicine And Haematology
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status: Published
Appears in Collections:National Heart and Lung Institute