Pseudoresistant hypertension caused by inappropriate drug regimen

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.32004

Keywords:

Resistant hypertension; Prescription; Drug therapy.

Abstract

Background: The diagnosis of resistant hypertension (RHTN) requires the identification and exclusion of pseudoresistance cases, which is due to poor blood pressure measurement technique, white coat hypertension, low medication adherence, and/or inappropriate drug regimen. Aim: This study aimed to assess the prevalence of pseudoresistant hypertension (pRHTN) caused by Inappropriate Drug Regimen (IDR). Methods: A cross-sectional study was carried out with patients seen in primary care in Maceió, Brazil, between December 2013 and February 2014. Patients diagnosed with hypertension and undergoing drug treatment were included. Patients were assessed for medication use, analysis of the antihypertensive drug regimen, medication adherence, values ​​for Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). Results: 183 patients were included in the study, of which 8 (4.3%) had RHTN and 12 (6.6%) had pRHTN. All patients with pRHTN had IDR. Also, 74.8% of patients with primary hypertension were exposed to IDR (p = 0.000). The most frequent type of IDR among patients with pRHTN was therapeutic inertia. Conclusion: Thus, we conclude that IDR is recurrent among patients with pRHTN and therapeutic inertia was the most frequent type of IDR.

References

Alessi, A., Brandão, A. A., Coca, A., Cordeiro, A. C., Nogueira, A. R., Diógenes de Magalhães, F., et al. (2013) First Brazilian position on resistant hypertension. Arq Bras Cardiol. 2012;99(1):576-85. Erratum in: Arq Bras Cardiol. ;100(3):304.

Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Mota-Gomes, M. A., Brandão, A. A., Feitosa, A. D. M., et al. (2020). Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arq Bras Cardiol. 2021; 116(3):516-658

Bhatt, H., Siddiqui, M., Judd, E., Oparil, S., & Calhoun, D. (2016). Prevalence of pseudoresistant hypertension due to inaccurate blood pressure measurement. J Am Soc Hypertens. Jun;10(6):493-9

Briasoulis, A., Androulakis, E., Palla, M., Papageorgiou, N., & Tousoulis, D. (2016) White-coat hypertension and cardiovascular events: a meta-analysis. J Hypertens.Apr;34(4):593-9. 10.1097/HJH.0000000000000832

Calhoun, D. A., Jones, D., Textor, S., Goff, D. C., Murphy, T. P., Toto, R. D., et al. (2008) Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension.;51(6):1403-19.

Calhoun, D. A.., & Grassi, G. (2017). True versus pseudoresistant hypertension. J Hypertens.Dec;35(12):2367-2368.

Calhoun, D. A. (2018). Advances in resistant hypertension. Ann Transl Med. 2018. 6(15):294.

Oliveira-Filho, A. D., Costa, F. A., Neves, S. J., de Lyra Junior, D. P., & Morisky, D. E. (2014). Pseudoresistant hypertension due to poor medication adherence. Int J Cardiol. 2014 Mar 15;172(2):e309-10.

de la Sierra, A., Segura, J., Banegas, J. R., Gorostidi, M., de la Cruz, J. J., Armario, P., et al. (2011). Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 57(5):898-902

Egan, B. M., Zhao, Y., Li, J., Brzezinski, W. A., Todoran, T. M., Brook, R. D., & Calhoun, D. A. (2013). Prevalence of optimal treatment regimens in patients with apparent treatment-resistant hypertension based on office blood pressure in a community-based practice network. Hypertension.Oct;62(4):691-7.

Faria, C., Wenzel, M., Lee, K. W., Coderre, K., Nichols, J., Belletti, D. A. (2009) A narrative review of clinical inertia: focus on hypertension. J Am Soc Hypertens. Jul-Aug;3(4):267-76. 10.1016/j.jash.2009.03.001.

Grigoryan, L., Pavlik, V. N., Hyman, D. J. (2013) Characteristics, drug combinations and dosages of primary care patients with uncontrolled ambulatory blood pressure and high medication adherence. J Am Soc Hypertens.Nov-Dec;7(6):471-6.

Hanlon, J. T., & Schmader, K. E. (2013). The medication appropriateness index at 20: where it started, where it has been, and where it may be going. Drugs & aging, 30(11), 893–900. https://doi.org/10.1007/s40266-013-0118-4

Hanlon, J. T., Schmader, K. E., Samsa, G. P., Weinberger, M., Uttech, K. M., Lewis, I. K., Cohen, H. J., & Feussner, J. R. (1992). A method for assessing drug therapy appropriateness. Journal of clinical epidemiology, 45(10), 1045–1051. https://doi.org/10.1016/0895-4356(92)90144-c

Holland, N., Segraves, D., Nnadi, V. O., Belletti, D. A., Wogen, J., & Arcona, S. (2008). Identifying barriers to hypertension care: implications for quality improvement initiatives. Disease management: DM, 11(2), 71–77. https://doi.org/10.1089/dis.2008.1120007

Lebeau, J. P., Cadwallader, J. S., Aubin-Auger, I., Mercier, A., Pasquet, T., Rusch, E., Hendrickx, K., & Vermeire, E. (2014). The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review. BMC family practice, 15, 130. https://doi.org/10.1186/1471-2296-15-130

Levy, P. D, Willock, R. J, Burla M, Brody A, Mahn J, Marinica A, et al. (2016) Total antihypertensive therapeutic intensity score and its relationship to blood pressure reduction. J Am Soc Hypertens.Dec;10(12):906-916. doi: 10.1016/j.jash.2016.10.005.

Makris A., Seferou M., & Papadopoulos D. P. (2010). Resistant hypertension workup and approach to treatment. Int J Hypertens. 26; 2011:598694.

Massierer, D., Oliveira, A. C., Steinhorst, A. M., Gus, M., Ascoli, A. M., Gonçalves, S. C., Moreira, L. B., Correa, V., Jr, Nunes, G., Fuchs, S. C., & Fuchs, F. D. (2012). Prevalence of resistant hypertension in non-elderly adults: prospective study in a clinical setting. Arquivos brasileiros de cardiologia, 99(1), 630–635. https://doi.org/10.1590/s0066-782x2012005000051

Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence. Medical Care, 24(1), 67–74. http://www.jstor.org/stable/3764638

Mu, L., & Mukamal, K. J. (2016). Treatment Intensification for Hypertension in US Ambulatory Medical Care. Journal of the American Heart Association, 5(10), e004188. https://doi.org/10.1161/JAHA.116.004188

National Institute for Health and Care Excellence (NICE). (2003): Clinical Guidelines. https://www.ncbi.nlm.nih.gov/books/NBK11822

Noubiap, J. J., Nansseu, J. R., Nkeck, J. R., Nyaga, U. F., & Bigna, J. J. (2018). Prevalence of white coat and masked hypertension in Africa: A systematic review and meta-analysis. Journal of clinical hypertension (Greenwich, Conn.), 20(8), 1165–1172. Advance online publication. https://doi.org/10.1111/jch.13321

Wolf-Maier, K., Cooper, R. S., Banegas, J. R., Giampaoli, S., Hense, H. W., Joffres, M, et al. (2003).Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. May 14;289(18):2363-9

Yang, P. J., Lee, Y. T., Tzeng, S. L., Lee, H. C., Tsai, C. F., Chen, C. C., Chen, S. C., & Lee, M. C. (2015). Potentially Inappropriate Prescribing in Disabled Older Patients with Chronic Diseases: A Screening Tool of Older Persons' Potentially Inappropriate Prescriptions versus Beers 2012 Criteria. Medical principles and practice: international journal of the Kuwait University, Health Science Centre, 24(6), 565–570. https://doi.org/10.1159/000435955

O'Connor M. N, Gallagher P., & O'Mahony D. (2012). Inappropriate prescribing: criteria, detection and prevention. Drugs Aging.Jun 1;29(6):437-52.

Pimenta E, Calhoun D. A., & Oparil S. (2007). Mechanisms and treatment of resistant hypertension. Arq Bras Cardiol.Jun;88(6):683-92.

Pimenta E., & Calhoun D. A. (2012). Resistant hypertension: incidence, prevalence, and prognosis. Circulation. Apr 3;125(13):1594-6.

Rouquayrol, M. Z., & Silva, M. G. C. (2018). Rouquayrol: epidemiologia & saúde. Medbook.

Salles, G. F., Cardoso, C. R., & Muxfeldt, E. S. (2008). Prognostic influence of office and ambulatory blood pressures in resistant hypertension. Archives of internal medicine, 168(21), 2340–2346. https://doi.org/10.1001/archinte.168.21.2340

Steinman, M. A., Landefeld, C. S., Rosenthal, G. E., Berthenthal D., Sen S, & Kaboli P. J. (2006). Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 54(10):1516-23.

Sociedade Brasileira de Cardiologia / Sociedade Brasileira de Hipertensão / Sociedade Brasileira de Nefrologia. (2010). VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol 2010; 95(1 supl.1): 1-51

Downloads

Published

14/07/2022

How to Cite

NASCIMENTO , V. B. .; SILVA, R. Z. da; CARVALHO, J. F. de .; LEOPARDI-GONÇALVES, M. das G. .; OLIVEIRA-FILHO, A. D. de; NEVES, S. J. F. . Pseudoresistant hypertension caused by inappropriate drug regimen. Research, Society and Development, [S. l.], v. 11, n. 9, p. e41611932004, 2022. DOI: 10.33448/rsd-v11i9.32004. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32004. Acesso em: 23 apr. 2024.

Issue

Vol. 11 No. 9

Section

Health Sciences

License

Copyright (c) 2022 Victor Barbosa Nascimento ; Rosileide Zeferino da Silva; Janaina Fraga de Carvalho; Maria das Graças Leopardi-Gonçalves; Alfredo Dias de Oliveira-Filho; Sabrina Joany Felizardo Neves

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.