[Therapy resistant hypertension--significance of electronic compliance monitoring].

HISTORY AND CLINICAL FINDINGS

A 71-year-old woman was admitted with arterial hypertension resistant to drug therapy (office readings 197/82 mmHg) under medication with beta-blocker, AT 1 -antagonist and a diuretic. The only physical pathologic finding was an adipositas.

DIAGNOSIS, TREATMENT AND COURSE: The patient was suffering from isolated systolic hypertension, grade 3 corresponding to WHO-guidelines. Despite antihypertensive triple therapy office as well as self-measured blood pressure values (mean 170/82 mmHg) remained elevated. Thus, the patient fulfilled the criteria of a resistant hypertension. The degree of compliance was only 50 %, detected by using a Medication-Event-Monitoring-System (correct dosing interval 17.1 %). We discussed the results of compliance- and blood pressure self-measurement with the patient. In the following period of compliance- and blood pressure self-measurement (with unchanged antihypertensive therapy) the compliance increased dramatically with a degree of 90,9 % and self-measured blood pressure values almost normalized (mean 137/71 mmHg).

CONCLUSION

The control of compliance by using electronic compliance-monitoring may help to discover non-compliance as a frequent cause of resistant hypertension and to avoid unnecessary cost-extensive procedures.