Intensive Monitoring of Adherence to Treatment Helps to Identify “True” Resistant Hypertension

Intensive monitoring of adherence in patients with uncontrolled hypertension was evaluated over a 6‐month period. After that period, only patients well characterized as having resistant hypertension were followed for 12 months. The goal of this study was to evaluate whether adherence to a drug regimen helps to identify patients with resistant hypertension. Forty‐four hypertensive patients resistant to a 3‐drug regimen (average blood pressure [BP] mm Hg, mean ± standard deviation) were studied prospectively. Each patient was followed for a 12‐month period. Adherence to treatment was evaluated through self‐report, applying Morisky’s questionnaire and the pill count method. Ambulatory BP monitoring and office BP measures were performed. By pill count, 63.6% of the patients were adherent to treatment at the start of the survey and 94% at the end, although 59% of the patients still did not reach normal BP levels. We found that non‐adherence was not associated with resistance to antihypertensive treatment. Therefore, after investigation, we concluded that patients who presented with uncontrolled arterial BP may be truly resistant hypertensive to treatment.