Resistant hypertension, therapieresistente hypertensie
Conditions
Interventions
Feedback of actual drug levels measured in a dried blood spot (DBS) obtained by a finger prick combined with supported problem solving: firstly, barriers to adherence will be discussed and suggestions
Sponsors
Erasmus Medical Centre
Eligibility
Inclusion criteria
Inclusion criteria: - Resistant hypertension: office blood pressure > 140/90 mmHg and 24h ABPM (ambulatory blood pressure measurement) daytime blood pressure > 135/85 mmHg despite a medication regimen of antihypertensive drugs from at least three classes including a diuretic. - Use of at least two drugs for which DBS-analysis is available (enalapril, perindopril, losartan, valsartan, hydrochlorothiazide, spironolactone, amlodipine and nifedipine. - Age 18 years and older - Providing informed consent after reading patient information
Exclusion criteria
Exclusion criteria: - Not providing informed consent or not capable of giving informed consent - Kidney transplantation - End-stage renal disease (eGFR<15 ml/min) „h - Insufficient understanding of Dutch or Turkish language - Secondary forms of hypertension (to be excluded according to local guidelines) except cases when a secondary form of hypertension has been established or is likely but chosen treatment is drug therapy (for instance primary hyperaldosteronism, renovascular hypertension).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - Determine whether measuring drug levels combined with personalized feedback leads to a decrease in resistant hypertension after 12 months of follow-up. | — |
Secondary
| Measure | Time frame |
|---|---|
| - determine percentage of assumed resistant hypertension at baseline due to non-adherence - Determine the percentage of patients with partial or non-adherence at baseline who are adherent after 12 months of follow-up - Determine whether the number of required antihypertensive drugs is lower in patients who receive feedback on drug levels than in patients who do not. - cost-utility of the intervention versus usual care in resistant hypertention - The number of patients fulfilling the definition of resistant hypertension after 3 and 6 months | — |
Contacts
Public ContactJorie Versmissen
Outcome results
None listed