New urine test shows poor adherence to antihypertensive therapy
A new study led by the University of Leicester suggests that one in three people who suffer from high blood pressure are failing to take medication as prescribed by their healthcare professionals. Non-adherence to antihypertensive treatment is a critical contributor to suboptimal blood pressure control.
The study on 1400 patients in the UK and Czech Republic used a novel urine test using liquid chromatography-tandem mass spectrometry which was simple, relatively inexpensive and robust, and could change the management of hypertension in many centres who use the test.
The study showed that more than 41.6% of the UK cohort and 31.5% of the Czech cohort were non-adherent to their anti-hypertensive medications. Moreover 14.5% of the UK and 12% of the Czech cohort were not taking any medications. Each increase in the number of antihypertensive medications led to 85% and 77% increase in non-adherence (p<0.001) in the UK and Czech populations, respectively. In addition, younger patients and females were found to have an increased risk of non-adherence to prescribed medications. Of the 5 classes of antihypertensive therapy, the highest level of non-adherence was found to be with diuretics (p≤0.005 in both populations).
The team has set up a National Centre for Drug Adherence Testing (NCAT) at Leicester’s Hospitals which now receives samples from around 25 hypertension clinics across UK.
Given the high prevalence of non-adherence shown in this study, health care professionals should consider assessing patients, particularly those on multiple antihypertensive medications or those who do not have an expected response to treatment.
Gupta P et al. Risk factors for non-adherence to antihypertensive treatment. Hypertension 2017; https://doi.org/10.1161/HYPERTENSIONAHA.116.08729