Improvement of non-adherence and reduction of BP values in patients with difficult-to-treat hypertension: the ATHAN clinical trial
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- dc.contributor.author Oliveras, Anna
- dc.contributor.author Vázquez, Susana
- dc.contributor.author Vega, María Victoria
- dc.contributor.author Camps, Carme
- dc.contributor.author Illana, Francisco J.
- dc.contributor.author Armario, Pedro
- dc.contributor.author Crespo Barrio, Marta
- dc.contributor.author Sierra, Alejandro de la
- dc.date.accessioned 2025-07-29T12:46:34Z
- dc.date.available 2025-07-29T12:46:34Z
- dc.date.issued 2024
- dc.description.abstract Hypertension treatment and blood pressure (BP) control reduce cardiovascular disease burden. However, prevalence of controlled BP is overall insufficient and lack of adherence to treatment is a suggested major contributor. This prospective, randomized clinical trial was designed to evaluate whether a specific 3-month (m) action plan to improve therapeutic adherence results in a decrease in BP. Patients with ambulatory 24 h-BP ≥ 130/80 mmHg despite receiving ≥2 antihypertensive drugs and with therapeutic non-compliance confirmed by antihypertensive drugs analyzed in urine were randomized (1:1) to receive a specific 3 m program to improve adherence (INT = intervention) or routine follow-up (C = control). Antihypertensive treatment was not modified and knowledge of non-adherence was only notified to patients randomized to the intervention group. Before randomization and at 3 m all patients underwent urinary screening for antihypertensive drugs and 24 h-ambulatory-BP monitoring. Forty-five patients (36% women, mean age: 58 ± 13 yr) were randomized. At 3 m, mean (95% CI) BP differences (INT vs. C) were 12.2 mmHg (4.3-20.8), adjusted-p = 0.032 and 8.7 mmHg (2.5-14.8), adjusted-p = 0.018 for 24 h-systolic and 24 h-diastolic BP, respectively. Differences (INT vs. C) for office SBP and DBP were 18.4 mmHg (6.8-30.1), adjusted-p = 0.005 and 15.7 mmHg (7.2-24.2), adjusted-p < 0.001. Non-detected antihypertensive drugs were median [IQR]: 40% [25-100] and 0% [0-20] at baseline and 3 m, respectively, in the INT group, and 33.3% [25-63.7] and 33.3% [23.8-57.9], in the C group (p < 0.001 for the 3-month between-group comparison). A combined action plan of notifying knowledge of non-adherence plus a 3-month specific nursing intervention to improve therapeutic adherence results in BP reduction in patients with inadequate therapeutic compliance.
- dc.format.mimetype application/pdf
- dc.identifier.citation Oliveras A, Vázquez S, Vega MV, Camps C, Illana FJ, Armario P, et al. Improvement of non-adherence and reduction of BP values in patients with difficult-to-treat hypertension: the ATHAN clinical trial. Hypertens Res. 2024 Oct;47(10):2864-73. DOI: 10.1038/s41440-024-01748-x
- dc.identifier.doi http://dx.doi.org/10.1038/s41440-024-01748-x
- dc.identifier.issn 0916-9636
- dc.identifier.uri http://hdl.handle.net/10230/71022
- dc.language.iso eng
- dc.publisher Nature Research
- dc.relation.ispartof Hypertens Res. 2024 Oct;47(10):2864-73
- dc.rights © Springer Nature Publishing AG [Oliveras A, Vázquez S, Vega MV, Camps C, Illana FJ, Armario P, et al. Improvement of non-adherence and reduction of BP values in patients with difficult-to-treat hypertension: the ATHAN clinical trial. Hypertens Res. 2024 Oct;47(10):2864-73. DOI: 10.1038/s41440-024-01748-x] [http://dx.doi.org/10.1038/s41440-024-01748-x]
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.subject.keyword Antihypertensive drugs
- dc.subject.keyword Blood pressure control
- dc.subject.keyword Therapeutic adherence
- dc.title Improvement of non-adherence and reduction of BP values in patients with difficult-to-treat hypertension: the ATHAN clinical trial
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/acceptedVersion