Drug resistance, inappropriate dosing and non‐compliance in hypertensive patients.

Abstract

1 From an understanding of the biological fate and hypotensive effect of debrisoquine (D) we have assessed the relative importance of true drug resistance, inappropriately low dosage and noncompliance as causes of apparent resistance to treatment with this drug.2 Among 37 hypertensive patients prescribed D, eleven (30%) were non-compliant on the day of testing.3 Non-compliance was found in 64% of patients with poor blood pressure control but only 15% of patients with intermediate and good blood pressure control (P < 0.02). 4 Five patients received doses which were too low for pharmacological effect while in a further five an increase in dose may have improved blood pressure control. 5 Resistance to D was uncommon indicating that non-compliance and inadequate dosing are the major causes of apparent resistance to treatment with this compound.