A pharmacodynamic assessment of the impact of antihypertensive non-adherence on blood pressure control

Pharmacoepidemiology and Drug Safety
P W ChooR Platt

Abstract

To evaluate if antihypertensive regimens that conform to present FDA guidelines by maintaining > or = 50% of their peak effect at the end of the dosing interval protect patients during sporadic lapses in adherence. 169 patients on monotherapy for high blood pressure underwent electronic adherence monitoring for 3 months. Blood pressures were measured during non-study office visits and were retrieved from automated medical records. Questionnaires were used to obtain other covariate information. The ratio of the dosing interval to the half-life of drug activity (I') was used to capture conformity with FDA guidelines. Data analysis focused on the interaction between I' and the impact on blood pressure of delayed dosing. The average (+/- standard deviation) blood pressure during the study was 139.0(+/- 12.0)/85.0(+/- 6.9) mm Hg. Lisinopril followed by sustained-release verapamil, atenolol, and hydrochlorothiazide were the most frequently prescribed agents. The majority of regimens (99%) conformed to FDA dosing guidelines. Of the patients 23% missed a dose before their blood pressure check. Non-adherence, however, did not have a direct impact on blood pressure, and no interaction with I' of was detected. Among patients with relative...Continue Reading

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References

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Citations

Feb 7, 2002·Pharmacoepidemiology and Drug Safety
Jul 7, 2015·Journal of Clinical Epidemiology·Sarah-Jo SinnottJoshua J Gagne
Jun 25, 2004·Advances in Chronic Kidney Disease·Judith Bernardini
Nov 25, 2005·Diabetes Care·Alyce S AdamsDennis Ross-Degnan
May 29, 2009·Journal of Hypertension·Arne ChristensenEbba Holme Hansen
Nov 17, 2019·Tropical Medicine & International Health : TM & IH·Marissa Persaud-LachhmanLindsay M Jaacks
Jun 1, 2004·Expert Review of Pharmacoeconomics & Outcomes Research·Stefania LopatrielloPierfrancesco Ruffo

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