DRUG ADHERENCE AND PSYCHOLOGICAL FACTORS MATTER IN PATIENTS WITH RESISTANT HYPERTENSION - YES BUT WHICH ONES? in Journal of Hypertension
2022
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (11)Vedi tutti...
Toennes SW
Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Brussels, Belgium
Wallemacq P
Clincal Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
Fanelli E
Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Turin, Italy
et alii...
Abstract
Objective: Altered psychological profiles are associated with drug adherence and drug resistance in patients with resistant hypertension (RHTN). However, treatment resistance may also result from increased arterial stiffness and target organ damage. The aim of this study was to assess the association of psychological factors with both drug adherence and drug resistance in two subtypes of patients with RHTN: younger patients without cardiovascular complications versus older or vascular patients. Design and method: Ninety-seven patients with RHTN were enrolled and split in two groups: patients 60y or older or with previous cardiovascular diseases (VRHTN), and younger patients without cardiovascular complications (NVRHTN). Drug adherence was assessed by urinary Liquid Chromatography coupled with tandem Mass Spectrometry. Drug resistance was evaluated by 24-hour ambulatory blood pressure adjusted for the number of antihypertensive drugs and drug adherence. Psychological profile was assessed using five validated questionnaires: the Brief Symptom Inventory (BSI), the Toronto Alexithymia Scale (TAS-20), the Emotion Regulation Questionnaire (ERQ), the Cognitive Emotion Regulation Questionnaire (CERQ) and the Post Traumatic Diagnostic Scale (PDS). Results: The proportion of fully adherent, partly adherent, and totally non-adherent patients was significantly different between NVRHTN (37, 39 and 24%) and VRHTN (67, 26 and 7 %) respectively (p-value = 0.010). After multiple regression analysis, independent predictors of poor drug adherence in NVRHTN were “adaptive strategies”, male gender and family history of hypertension, accounting for 39.2% of the variability. Independent predictors of drug resistance were difficulties in planification and somatization, accounting for 39.0% of the variability. In the VRHTN group, predictors of drug adherence were yearly number of visits at the emergency department for hypertension and family history of cardiovascular events, acco
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DOI : 10.1097/01.hjh.0000838776.15594.e8
Keywords
antihypertensive agent; adult; blood pressure monitoring; Brief Symptom Inventory; cardiovascular disease; Cognitive Emotion Regulation Questionnaire; conference abstract; emergency ward; family history; female; gender; human; hypertension; liquid chromatography; major clinical study; male; medication compliance; multiple regression; psychologic assessment; psychological aspect; resistant hypertension; somatization; tandem mass spectrometry; Toronto Alexithymia scale;