Medication adherence and treatment-resistant hypertension: a review

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Nonadherence is a common reason for treatment failure and treatment resistance. No matter how it is defined, it is a major issue in the management of chronic illnesses. There are numerous methods to assess adherence, each with its own strengths and weaknesses; however, no single method is considered the best. Nonadherence is common in patients with hypertension, and it is present in a large proportion of patients with uncontrolled blood pressure taking three or more antihypertensive agents. Availability of procedure-based treatment options for these patients has shed further light on this important issue with development of new methods to assess adherence. There is, however, no consensus on the management of nonadherence, which reflects the complex interplay of factors responsible for it.

Keywords: adherence, compliance, treatment-resistant hypertension.

Citation: Hameed MA, Dasgupta I. Medication adherence and treatmentresistant hypertension: a review. Drugs in Context 2019; 8: 212560. DOI: 10.7573/dic.212560

Contributions: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that there is no conflict of interest in preparing this article. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at

Acknowledgements: None.

Funding declaration: No grants or fees were received by the authors in preparation of this manuscript. ID received an unrestricted research grant from Medtronic.

Copyright: Copyright © 2019 Hameed MA, Dasgupta I. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Hameed MA, Dasgupta I. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Indranil Dasgupta, Department of Renal Medicine, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK.

Provenance: invited; externally peer reviewed.

Submitted: 21 September 2018; Peer review comments to author: 19 October 2018; Revised manuscript received: 28 December 2018; Accepted: 2 January 2019; Publication date: 4 February 2019.

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