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Evidence of Nonadherence in Cases of Pseudoresistant Hypertension

Authors Zanatta JMM, Cosenso-Martin LN, da Silva Lopes V, Roma Uyemura JR, Polegati Santos AM, Paz Landim MI, Yugar-Toledo JC, Vilela-Martin JF

Received 12 June 2020

Accepted for publication 26 September 2020

Published 11 February 2021 Volume 2021:14 Pages 9—17


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Turgay Celik

João Marcos de Menezes Zanatta, Luciana Neves Cosenso-Martin, Valquíria da Silva Lopes, Jéssica Rodrigues Roma Uyemura, Aleandra Marton Polegati Santos, Manoel Ildefonso Paz Landim, Juan Carlos Yugar-Toledo, José Fernando Vilela-Martin

Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil

Correspondence: José Fernando Vilela-Martin
Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), 5416 Avenida Brigadeiro Faria Lima, Sao Jose Do Rio Preto, SP, 15090-000, Brazil
Tel +55 17 3201-5727

Abstract: Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.

Keywords: hypertension, resistant hypertension, medication adherence

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