Blood pressure reductions following catheter-based renal denervation are not related to improvements in adherence to antihypertensive drugs measured by urine/plasma toxicological analysis.

Détails

ID Serval
serval:BIB_697C420670D8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Blood pressure reductions following catheter-based renal denervation are not related to improvements in adherence to antihypertensive drugs measured by urine/plasma toxicological analysis.
Périodique
Clinical Research In Cardiology : Official Journal of the German Cardiac Society
Auteur(s)
Ewen S., Meyer M.R., Cremers B., Laufs U., Helfer A.G., Linz D., Kindermann I., Ukena C., Burnier M., Wagenpfeil S., Maurer H.H., Böhm M., Mahfoud F.
ISSN
1861-0692 (Electronic)
ISSN-L
1861-0684
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
104
Numéro
12
Pages
1097-1105
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Renal denervation can reduce blood pressure in patients with uncontrolled hypertension. The adherence to prescribed antihypertensive medication following renal denervation is unknown. This study investigated adherence to prescribed antihypertensive treatment by liquid chromatography-high resolution tandem mass spectrometry in plasma and urine at baseline and 6 months after renal denervation in 100 patients with resistant hypertension, defined as baseline office systolic blood pressure ≥140 mmHg despite treatment with ≥3 antihypertensive agents. At baseline, complete adherence to all prescribed antihypertensive agents was observed in 52 patients, 46 patients were partially adherent, and two patients were completely non-adherent. Baseline office blood pressure was 167/88 ± 19/16 mmHg with a corresponding 24-h blood pressure of 154/86 ± 15/13 mmHg. Renal denervation significantly reduced office and ambulatory blood pressure at 6-month follow-up by 15/5 mmHg (p < 0.001/p < 0.001) and 8/4 mmHg (p < 0.001/p = 0.001), respectively. Mean adherence to prescribed treatment was significantly reduced from 85.0 % at baseline to 80.7 %, 6 months after renal denervation (p = 0.005). The blood pressure decrease was not explained by improvements in adherence following the procedure. Patients not responding to treatment significantly reduced their drug intake following the procedure. Adherence was highest for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and beta blockers (>90 %) and lowest for vasodilators (21 %). In conclusion, renal denervation can reduce office and ambulatory blood pressure in patients with resistant hypertension despite a significant reduction in adherence to antihypertensive treatment after 6 months.
Mots-clé
Aged, Antihypertensive Agents/administration & dosage, Antihypertensive Agents/therapeutic use, Blood Pressure/drug effects, Blood Pressure Monitoring, Ambulatory, Chromatography, Liquid/methods, Female, Follow-Up Studies, Humans, Hypertension/drug therapy, Hypertension/physiopathology, Male, Medication Adherence, Middle Aged, Prospective Studies, Sympathectomy/methods, Tandem Mass Spectrometry/methods
Pubmed
Web of science
Création de la notice
22/12/2015 18:19
Dernière modification de la notice
20/08/2019 15:24
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