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REFLECTIONS
Hypertension
Hypertension Global Newsletter #6 2024

CLINICAL PEARLS FROM THE FACULTY CLICK HERE Hypertension
FOR THE LINK TO FULL ARTICLE

WATCH
PROF. LAURENT DISCUSS THE HOW
THIS OVERVIEW OF LANDMARK
TRIALS IN PATIENTS WITH
HYPERTENSION HAVE SHAPED
CLINICAL PRACTICE.

A practical approach to assessment of non-adherence to antihypertensive

treatment.
Kociánová E, et al. J Hypertens. 2023 Sep 1;41(9):1371-1375.

Non-adherence to antihypertensive treatment is a frequent occurrence that can complicate the care of hypertensive patients
and increase the risk of cardiovascular events. It is considered one of the major causes of treatment failure. The authors review
the factors that contribute to non-adherence, outline red flags for recognising non-adherence, discuss how to check for non-
adherence with patients, including confrontation with the patient and additional testing, and finally provide some solutions on
how to address non-adherence.

The World Health Organization (WHO) identified five main non-adherence dimensions: Socioeconomic, patient-related,
treatment-related, disease-related, and healthcare system-related factors.

The authors contrast the causes of
apparently resistant hypertension,
including pseudo resistant and true
resistant hypertension, for which
non-adherence is one likely cause of
pseudo resistant hypertension. Other
causes may include measurement
errors, white coat syndrome,
therapeutic inertia, etc. They discuss
both direct and indirect methods of
assessing adherence, including the
sensitivity, ease of implementation, and
accuracy of the different methods.

The authors suggest a simple
algorithmic approach to detect and
address non-adherence in the clinical
setting.

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