Division of Nephrology Department of Medicine, Sidney Kimmel School of Medicine Thomas Jefferson University, 833 Chestnut Street Suite 700, Philadelphia, PA, 19107, USA.
Curr Cardiol Rep. 2020 Sep 10;22(11):133. doi: 10.1007/s11886-020-01400-3.
As the global burden of hypertension continues to rise, it remains suboptimally controlled despite increased awareness. Poor medication adherence is a well-recognized although underestimated contributing factor of uncontrolled hypertension. This review focuses on medication non-adherence as an important cause of apparent treatment-resistant hypertension and its impact on patient's well-being.
In addition to biochemical screening, electronic technology-including electronic medication packaging devices such as medication event monitoring system, device integrated care delivery systems like digital medicine, and blood pressure telemonitoring-provides reliable objective data that enables healthcare providers to make decisions that enhance adherence and improve blood pressure control. Consistent medication adherence is a key factor to sustained blood pressure control. Evaluation and correct assessment for adherence should be an integral part of management of patients with apparent treatment-resistant hypertension. Clinicians need to recognize key clues linked to suboptimal adherence or non-adherence that can result in poor outcomes.
尽管高血压的知晓率有所提高,但由于全球高血压负担持续增加,高血压的控制情况仍不理想。药物治疗依从性差是导致高血压控制不佳的一个公认但被低估的因素。本综述重点讨论了药物治疗依从性作为明显治疗抵抗性高血压的重要原因及其对患者健康的影响。
除了生化筛查外,电子技术——包括电子药物包装设备,如药物事件监测系统、设备集成护理输送系统,如数字药物,以及血压远程监测——提供了可靠的客观数据,使医疗保健提供者能够做出决策,提高依从性并改善血压控制。持续的药物治疗依从性是维持血压控制的关键因素。评估和正确评估依从性应该是治疗明显治疗抵抗性高血压患者管理的一个组成部分。临床医生需要认识到与治疗依从性差或不依从性相关的关键线索,这些线索可能导致不良结果。