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  2. Palavra-chave: Drug Resistance
IJCS
Original Article

Drug Profile and Therapeutic Adherence of African-Brazilians with Apparent Resistant Hypertension

Pedro Henrique Andrade Araújo Salvatore Barletta et al. Júlia Lasserre Moreira Vitor Fernandes de Almeida Mateus Andrade Bomfim Machado … Breno Lima de Almeida Tayla Samanta Silva dos Santos Yana Mendonça Nascimento Thaise Almeida Silva Roque Aras Cristiano Macedo

Abstract

Background

Resistant hypertension (RH) is manifested by the presence of blood pressure values resistant to antihypertensive therapy. RH is highly prevalent among black individuals, increasing cardiovascular risk in this population and requiring effective control of this comorbidity.

Objectives

To investigate the medication profile and therapeutic adherence in black people with apparent RH.

Methods

This is a cross-sectional study, with a convenience sample of individuals with apparent RH. Data were obtained from medical records. Therapeutic adherence was assessed using the Morisky Therapeutic Adherence Scale of 8 items (MMAS-8) and statistical analysis was performed using the SPSS, version 23. Significance was set at p <0.05.

Results

Of the 120 individuals, 90 (75%) were women and 72 (60%) were black. Mean SBP was 153.09 (SD 25.59) mm Hg and mean DBP, 90.82 (SD 16.91) mm Hg, with a statistical difference in relation to the target pressure for SBP. Regarding the medication profile, 79.2% of the individuals used the recommended regimen for RH (ACEI / ARB + Diuretic + CCB), with the fourth most used drug being beta-blockers. The average score in MMAS-8 was 6.62 (SD 1.38) points, with 19.2%, 50.0%, and 30.8% showing low, medium, and high adherence, respectively.

Conclusions

It was evidenced that two-thirds of the individuals did not have high therapeutic adherence and not all used the ideal regimen for the management of RH, nor full doses. Thus, most individuals were probably affected by pseudoresistance, which was initially diagnosed as apparent RH. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

  • African Continental Ancestry Group
  • Antihipertensive Agents
  • Blood pressure
  • Drug Resistance
  • Hypertension
  • medication adherence
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Creative Commons Attribution (CC BY) Creative Commons license
22/02/2021 DOI: 10.36660/ijcs.20200117
IJCS
Editorial

The Challenge of Controlling Resistant Hypertension

Marcus Vinicius Bolivar Malachias

Hypertension is the main risk factor for cardiovascular disease, stroke, disability and death. Despite the accumulated knowledge about hypertension and many treatment options, some hypertensive patients do not achieve the recommended blood pressure goals even receiving non-pharmacological treatment and three antihypertensive drugs. These individuals have the so-called “resistant hypertension” and are at increased risk of involvement of target organs, higher morbidity and mortality.

Several international scientific societies, including the Brazilian Society of Cardiology, have dedicated to publishing evidence-based guidelines for the management of arterial hypertension,, and specific position statements on resistant hypertension have also been produced., The Department of Hypertension of the Brazilian Society of Cardiology is about to issue an updated statement on the subject.

[…]

  • Blood pressure
  • Drug Resistance
  • Hypertension/prevention and control
  • medication adherence
  • Morbidity
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Creative Commons Attribution (CC BY) Creative Commons license
03/04/2020 DOI: 10.36660/ijcs.20200009 Visualizações 1
IJCS
Original Article

Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension

Luciana Baltazar da Silveira de Araújo et al. Roque Aras Junior

Abstract

Background:

Resistant hypertension (RH) consists of increased blood pressure (BP) despite the use of 3 or more antihypertensives or BP control only when is use of 4 or more antihypertensives. It is fundamental to exclude pseudoresistance, which can be attributed to poor therapeutic adherence. Adherence evaluation, generally by the Morisky-Grenn test, is important because, when appropriate, it is associated with fewer cardiovascular complications and better BP control.

Objectives:

To evaluate the adherence of patients with RH and to investigate its relation with epidemiological, anthropometric and clinical characteristics, as well as to estimate the prevalence of pseudoresistance and to outline strategies to improve adherence.

Methods:

Retrospective observational cohort from an interview with patients followed at an outpatient clinic for RH. Therapeutic adherence, demographic, anthropometric data, cardiovascular risk factors, comorbidities, complementary exams and BP level were collected. One-way ANOVA and Student’s t-tests were used for normal variables, and the Kruskal-Wallis and Mann-Whitney tests were used for non-normal tests. Categorical variables were compared using the Chi-Square test. We considered a 5% significance level in all tests.

Results:

217 individuals were included. Of these, 17% had poor adherence. Epidemiological and clinical characteristics, complications, comorbidities, BP level or drugs used were statistically insignificant between groups. The poor adherence group used significantly more drugs (p = 0.0313) and 28% of pseudoresistance was estimated.

Conclusions:

Most of the individuals presented good therapeutic adherence by the Morisky test. Only the number of antihypertensive drugs had a statistically significant influence on adherence, while the epidemiological, anthropometric and clinical characteristics were statistically insignificant.

  • Antihypertensive Agents/pharmacology
  • Antihypertensive Agents/therapeutic use
  • Blood Pressure Determination
  • Drug Resistance
  • Hypertension
  • Life Style
  • Prognosis
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Creative Commons Attribution (CC BY) Creative Commons license
24/10/2019 DOI: 10.5935/2359-4802.20190077 Visualizações 1

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Barletta PHAAS, Moreira JL, Almeida VF, Machado MAB, Almeida BL, Santos TSS, Nascimento YM, et al. Drug Profile and Therapeutic Adherence of African-Brazilians with Apparent Resistant Hypertension. International Journal of Cardiovascular Sciences 2021;34(3):300-6.

Formato de Documento Eletrônico (ABNT)

Barletta, Pedro Henrique Andrade Araújo Salvatore; Moreira, Júlia Lasserre; Almeida, Vitor Fernandes de; Machado, Mateus Andrade Bomfim; Almeida, Breno Lima de; Santos, Tayla Samanta Silva dos; Nascimento, Yana Mendonça; Silva, Thaise Almeida; Aras, Roque; Macedo, Cristiano. Drug Profile and Therapeutic Adherence of African-Brazilians with Apparent Resistant Hypertension. International Journal of Cardiovascular Sciences, v. 34, n. 3, p. 300-306, fev. 2021.

Formato de Documento Eletrônico (APA)

Barletta, P. H. A. A. S., Moreira, J. L., Almeida, V. F. , Machado, M. A. B., Almeida, B. L. , Santos, T. S. S. , Nascimento, Y. M., Silva, T. A., Aras, R., & Macedo, C. (2021). Drug Profile and Therapeutic Adherence of African-Brazilians with Apparent Resistant Hypertension. International Journal of Cardiovascular Sciences, 34(3), 300-306.

Formato de Documento Eletrônico (ISO)

Barletta, Pedro Henrique Andrade Araújo Salvatore and Moreira, Júlia Lasserre and Almeida, Vitor Fernandes de and Machado, Mateus Andrade Bomfim and Almeida, Breno Lima de and Santos, Tayla Samanta Silva dos and Nascimento, Yana Mendonça and Silva, Thaise Almeida and Aras, Roque and Macedo, Cristiano. Drug Profile and Therapeutic Adherence of African-Brazilians with Apparent Resistant Hypertension. International Journal of Cardiovascular Sciences [online]. 2021, vol. 34, n. 3, [citado 2026-10-14], pp. 300-306. Disponível em: <https://journals.cardiol.br/article/drug-profile-and-therapeutic-adherence-of-african-brazilians-with-apparent-resistant-hypertension-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Malachias MVB. The Challenge of Controlling Resistant Hypertension. International Journal of Cardiovascular Sciences 2020;33(2):119-20.

Formato de Documento Eletrônico (ABNT)

Malachias, Marcus Vinicius Bolivar. The Challenge of Controlling Resistant Hypertension. International Journal of Cardiovascular Sciences, v. 33, n. 2, p. 119-120, abr. 2020.

Formato de Documento Eletrônico (APA)

Malachias, M. V. B. (2020). The Challenge of Controlling Resistant Hypertension. International Journal of Cardiovascular Sciences, 33(2), 119-120.

Formato de Documento Eletrônico (ISO)

Malachias, Marcus Vinicius Bolivar. The Challenge of Controlling Resistant Hypertension. International Journal of Cardiovascular Sciences [online]. 2020, vol. 33, n. 2, [citado 2026-10-14], pp. 119-120. Disponível em: <https://journals.cardiol.br/article/the-challenge-of-controlling-resistant-hypertension-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Araújo LBS, Aras Junior R. Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension. International Journal of Cardiovascular Sciences 2019;33(2):121-30.

Formato de Documento Eletrônico (ABNT)

Araújo, Luciana Baltazar da Silveira de; Aras Junior, Roque. Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension. International Journal of Cardiovascular Sciences, v. 33, n. 2, p. 121-130, out. 2019.

Formato de Documento Eletrônico (APA)

Araújo, L. B. S. , & Aras Junior, R. (2019). Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension. International Journal of Cardiovascular Sciences, 33(2), 121-130.

Formato de Documento Eletrônico (ISO)

Araújo, Luciana Baltazar da Silveira de and Aras Junior, Roque. Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension. International Journal of Cardiovascular Sciences [online]. 2019, vol. 33, n. 2, [citado 2026-10-14], pp. 121-130. Disponível em: <https://journals.cardiol.br/article/association-between-therapeutic-adherence-and-the-profile-of-patients-with-resistant-hypertension-2/>. ISSN 2359-4802

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