Non-compliance and inertia in hypertensive Spaniards at high cardiovascular risk: CUMPLE study

Márquez-Contreras, Emilio; Gil-Guillén, Vicente Francisco; Wichmann, Mariano De La Figuera-Von; Franch-Nadal, Josep; Llisterri-Caro, J.L.; Martell-Clarós, Nieves; Pablos, José Luis Martín-de; Casado-Martínez, José Joaquín; Bertomeu‐González, Vicente; Martínez, Salvador Pertusa; Carratalá‐Munuera, Concepción; Orozco‐Beltrán, Domingo; López-Pineda, Adriana

doi:10.1185/03007995.2013.849237

Cited by 14 publications

(7 citation statements)

References 27 publications

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“…In Symplicity HTN‐3, African American participants were taking a greater number of antihypertensive medications and had more complex medication regimens than non–African Americans . Individuals with complex drug regimens or who are prescribed a greater number of medications may be particularly likely to be nonadherent and hence more vulnerable to a Hawthorne effect if enrolled in a clinical trial . Hameed and colleagues addressed this issue by using directly observed medication administration with subsequent BP monitoring to confirm adherence prior to RDN.…”

Section: Resultsmentioning

confidence: 99%

Controversies Surrounding Renal Denervation: Lessons Learned From Real‐World Experience in Two United Kingdom Centers

Burchell

Chan

Ratcliffe

et al. 2016

J of Clinical Hypertension

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Renal denervation (RDN) is a therapy that targets treatment‐resistant hypertension (TRH). The Renal Denervation in Patients With Uncontrolled Hypertension (Symplicity) HTN‐1 and Symplicity HTN‐2 trials reported response rates of >80%; however, sham‐controlled Symplicity HTN‐3 failed to reach its primary blood pressure (BP) outcome. The authors address the current controversies surrounding RDN, illustrated with real‐world data from two centers in the United Kingdom. In this cohort, 52% of patients responded to RDN, with a 13±32 mm Hg reduction in office systolic BP (SBP) at 6 months (n=29, P=.03). Baseline office SBP and number of ablations correlated with office SBP reduction (R=−0.47, P=.01; R=−0.56, P=.002). RDN appears to be an effective treatment for some patients with TRH; however, individual responses are highly variable. Selecting patients for RDN is challenging, with only 10% (33 of 321) of the screened patients eligible for the study. Medication alterations and nonadherence confound outcomes. Adequate ablation is critical and should impact future catheter design/training. Markers of procedural success and improved patient selection parameters remain key research aims.

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Section: Resultsmentioning

confidence: 99%

Controversies Surrounding Renal Denervation: Lessons Learned From Real‐World Experience in Two United Kingdom Centers

Burchell

Chan

Ratcliffe

et al. 2016

J of Clinical Hypertension

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show abstract

“…Thus, home BP monitoring may be a good recommendation in patients who have diffi culties with their treatment and are at high risk of not staying on therapy [ 47 ]. On their side, physicians also need to be motivated and should avoid medical inertia in order to show patients that they are eager to achieve the BP goals in order to preserve their patients' health [ 48 ].…”

Section: Strategies To Improve Drug Adherence In Hypertensionmentioning

confidence: 97%

Drug Adherence in Hypertension

Burnier¹

2015

Pathophysiology and Pharmacotherapy of Cardiovascular Disease

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The treatment of essential hypertension is based essentially on nonpharmacological recommendations and on the prescription of blood pressure lowering drugs and/or diuretics. Because of the silent nature of hypertension, long-term adherence to therapy is one of the major issues of the management of hypertensive therapy. Indeed, it is well recognized that many patients interrupt their antihypertensive treatment completely after 1 year, and this lack of persistence has a major impact on our ability to control blood pressure in the hypertensive population. Today, there are multiple ways of assessing drug adherence in patients, but only very few of them are accurate, and the most accurate ones are diffi cult to implement in clinical practice. Thus, physicians have no real capacity to establish a correct diagnosis of nonpersistence or poor adherence even in high-risk patients such as patients with resistant hypertension. Therefore, there is an urgent need to develop new techniques or devices to help physicians in their ability to handle adherence to therapy and to improve blood pressure control in the population.

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“…One of these is physician adherence to the prescribing recommendations in whichever guideline(s) they choose to read. Physician adherence is far from optimal in numerous geographic regions, and therapeutic inertia is widely discussed in the literature . Another is patient adherence to prescribed treatment regimens .…”

Section: Treatment‐resistant Hypertensionmentioning

confidence: 99%

Hypertension Guidances Published in 2013: A Busy Year With More to Follow

Turner

Kothari

2014

J of Clinical Hypertension

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Non-compliance and inertia in hypertensive Spaniards at high cardiovascular risk: CUMPLE study

Abstract: Among uncontrolled hypertensive patients, after completing 6 months follow-up, approximately one out of two patients were NC and one out of three physicians committed TI.

Cited by 14 publications

References 27 publications

Controversies Surrounding Renal Denervation: Lessons Learned From Real‐World Experience in Two United Kingdom Centers

Controversies Surrounding Renal Denervation: Lessons Learned From Real‐World Experience in Two United Kingdom Centers

Drug Adherence in Hypertension

Hypertension Guidances Published in 2013: A Busy Year With More to Follow

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