Nearly 20% of people with hard-to-treat high blood pressure are not taking all of their medication as directed. Even more troubling, an additional 20% don’t take any of the drugs they are prescribed.
Resistant hypertension is defined as having high blood pressure despite taking 3 or more medications to control it. But new research out of the Netherlands indicates that many of these people – who often seek a medical specialist – may go through unnecessary tests since the lack of medication adherence can result in resistant hypertension.
In the study, researchers randomly assigned 95 patients to undergo renal denervation – a treatment used in resistant hypertension – while not changing the meds they were taking. Renal denervation uses a catheter inserted into a blood vessel in the groin and fed until it enters the artery feeding the kidney. Radio waves or ultrasound destroy sections of the nerves sending messages between the brain and the kidneys. A control group of 44 patients just remained on their drugs.
Results showed that 31% of patients either improved or lessened their medication compliance. And in patients who had a similar amount of medication in their blood at each assessment, those receiving renal denervation saw their systolic blood pressure fall by a few points more than those in the control group.
“At a minimum, be open and honest and tell your physician if you don’t want to take your pills for any reason,” said Peter Blankestijn, MD, PhD, the study’s senior author and professor of nephrology and hypertension at the University Medical Center Utrecht. “You and your doctor can discuss options for changing the type of pill or the dose if needed. There are many effective blood pressure pills and the majority of patients with high blood pressure can be successfully treated.”