de Souza Walnéia Aparecida, Sabha Maricene, de Faveri Favero Fabrício, Bergsten-Mendes Gun, Yugar-Toledo Juan Carlos, Moreno Heitor
Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil.
J Clin Hypertens (Greenwich). 2009 Apr;11(4):183-91. doi: 10.1111/j.1751-7176.2009.00102.x.
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.
在6个月的时间里对血压控制不佳的高血压患者的依从性进行了强化监测。在那段时间之后，仅对明确诊断为顽固性高血压的患者进行了12个月的随访。本研究的目的是评估坚持药物治疗方案是否有助于识别顽固性高血压患者。对44例对三联药物治疗方案耐药的高血压患者（平均血压[BP]，毫米汞柱，均值±标准差）进行了前瞻性研究。每位患者随访12个月。通过自我报告、应用Morisky问卷和药丸计数法评估治疗依从性。进行了动态血压监测和诊室血压测量。通过药丸计数法，在调查开始时63.6%的患者坚持治疗而在结束时为94%，尽管59%的患者仍未达到正常血压水平。我们发现不依从与抗高血压治疗耐药无关。因此，经过调查，我们得出结论，动脉血压控制不佳的患者可能确实是对治疗耐药的高血压患者。
