Evidence of Nonadherence in Cases of Pseudoresistant Hypertension

• Published in: Integrated blood pressure control Vol. 14; pp. 9 - 17
• Main Authors: Zanatta, João Marcos de Menezes, Cosenso-Martin, Luciana Neves, da Silva Lopes, Valquíria, Roma Uyemura, Jéssica Rodrigues, Polegati Santos, Aleandra Marton, Paz Landim, Manoel Ildefonso, Yugar-Toledo, Juan Carlos, Vilela-Martin, José Fernando
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove
• Subjects: Analysis; Antihypertensives; Blood pressure; Care and treatment; Case Report; Case reports; Cholesterol; Diuretics; Drug dosages; Enzymes; Health aspects; Heart rate; Hydrochlorothiazide; Hypertension; Patient compliance; Thyroid gland; Valsartan; Brazil; United States > US; hypertension; resistant hypertension; medication adherence
• ISSN: 1178-7104; 1178-7104
• DOI: 10.2147/IBPC.S264057

Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.