Medication Non-adherence: a Major Cause of Resistant Hypertension

Abstract

Purpose of review: 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.

Recent findings: 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.

Keywords: Blood pressure; Cardiovascular disease; Hypertension; Medication adherence; Pseudo-resistant hypertension; Resistant hypertension.