Anti-hypertensive medication adherence in the REQUIRE trial: post-hoc exploratory evaluation

Maintaining medication adherence is important in treating hypertension, especially resistant hypertension (RH), and variable medication adherence can confound results in blood pressure trials. This post-hoc analysis evaluated adherence at baseline and 3 months using available urine samples from the...

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Bibliographic Details
Published in:Hypertension research 2023-08, Vol.46 (8), p.2044-2047
Main Authors: Kario, Kazuomi, Kai, Hisashi, Nanto, Shinsuke, Yokoi, Hiroyoshi
Format: Article
Language:English
Subjects:
Antihypertensive Agents - pharmacology
Antihypertensive Agents - therapeutic use
Antihypertensives
Blood pressure
Blood Pressure - physiology
Blood Pressure Monitoring, Ambulatory
Brief Communication
Denervation
Drugs
Humans
Hypertension
Hypotension
Kidney
Medication Adherence
Medicine
Patient compliance
Prospective Studies
Sympathectomy - methods
Treatment Outcome
Ultrasonic imaging
Urine
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Summary:Maintaining medication adherence is important in treating hypertension, especially resistant hypertension (RH), and variable medication adherence can confound results in blood pressure trials. This post-hoc analysis evaluated adherence at baseline and 3 months using available urine samples from the REQUIRE trial, comparing 24-h ambulatory systolic blood pressure (ASBP) lowering effects of ultrasound renal denervation (uRDN) versus sham in RH. At baseline, 45% (26/58) patients showed poor adherence. Among patients with good baseline adherence, adherence was unchanged at 3 months, and uRDN patients had a decreased ASBP whereas sham patients did not. In poorly adherent patients, sham patients showed a trend towards increased adherence and a significant ASBP reduction, whereas uRDN patients did not change. Accordingly, adherence changes and the resultant ASBP reduction in poorly adherent sham patients may explain the lack of between-group difference seen in REQUIRE. Monitoring and maintaining medication adherence is important for future interventional studies in RH.
ISSN:0916-9636
1348-4214
DOI:10.1038/s41440-023-01333-8