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1 in 4 Dont Take High Blood Pressure Meds Correctly: Do You?

By Everyday Health | Healthy Living Thu, Apr 17, 2014 3:19 PM EDT

By Jennifer Brown, PhD, Everyday Health

Sometimes medication is simply not enough to control high blood pressure - or so doctors
thought. But in their search for why some patients don't respond to treatment, a team of
researchers found many were in fact not taking their drugs at all, based on levels of the
medications in their urine samples.
Lead investigator Maciej Tomaszewski, MD, and others make the case for using a simple
urinanalysis to check whether patients with "resistant" hypertension actually take the drugs they
were prescribed. The results of their research at the University of Leicester in the UK were
published this week in the journal Heart.
Barriers to Getting Hypertension Under Control
High blood pressure puts you at risk for heart disease and stroke - two good reasons to get it
under control. Heart disease is the leading cause of death in the United States for both men and
women, yet many physicians believe it is preventable by effectively treating its root causes,
like hypertension. Currently about 67 million people in the United States - one in three adults have high blood pressure, according to the U.S. Centers for Disease Control and Prevention
One in three U.S. adults has high blood pressure.

(CDC).
RELATED: Green Tea May Interfere With a Blood Pressure Medicine

In the new study of 208 patients with high blood pressure, urine tests proved that 25 percent didn't take their anti-hypertension medications as
prescribed.
10 percent didn't take the medication at all, and had no trace of any anti-hypertension drug in their urine.
15 percent took the drugs less often than they should have according to their care plan.
Patients who failed to take the drugs had higher blood pressure readings - putting them at increased risk for heart disease and stroke than patients
who took medications as prescribed.
Surprisingly, the greater the number of drugs a person was prescribed (some people were taking up to seven different drugs), the less likely it was for
any drugs to show up in their urine - a paradox noted by Morris J. Brown, MD, Professor of Clinical Pharmacology at the University of Cambridge. Dr.
Brown was not involved in the study but wrote an accompanying editorial in Heart. In the most extreme cases, evidence from the screening test
showed no evidence of any drugs at all in urine samples of three patients who were each prescribed seven drugs in an attempt to control their
high blood pressure. They were simply not taking any of the drugs.
In some cases, patients had been labeled "resistant" to anti-hypertensive therapy, and physicians had escalated their treatment plans to add ever
more drugs. Because they were thought to be resistant to drug treatment, these patients were deemed candidates for a last-resort procedure to bring
down blood pressure that involves disrupting nerves leading to the kidney.
RELATED: Do You Have the High-Stress Gene?
But in fact, many of these patients were really resistant to taking more medications, rather than being resistant to the biochemical actions of the drugs
in their body.
True Drug-Resistant Hypertension Points to a Different Disease
It's critical to know if anti-hypertension drugs are working, because drug failure may point to a different disease condition underlying high blood
pressure. "A big plus for the patient with resistant hypertension is that where the urine profiling confirms that all the drugs are being taken, yet blood
pressure is markedly elevated, specialists like myself will now be keener than previously to look for a specific and sometimes curable cause,"
explained Dr. Brown in an interview.
RELATED: Doctors Really Do Raise Your Blood Pressure

He described two patients, each taking five hypertension drugs but who still had uncontrolled high blood pressure. They actually had benign,
hormone-secreting nodules in their adrenal glands, a condition called Conn's Syndrome. Brown said that removal of the nodules led to "complete
cure of the hypertension - no drugs required."
Don't Be an 'Untaker'
Researchers refer to patients who don't take drugs as prescribed as "untakers", "noncompliant" or "nonadherent" patients. Keeping up with multiple
medications is a challenge, but high blood pressure drugs work only if you take them.
RELATED: 10 Tension Tamers to Soothe Your Stress
Try these three strategies to stay on top of your pill schedule, suggested Brown:
Involve your partner - ask him or her to remind you.
Monitor your blood pressure at home so you can see the benefits of taking your medication.
Count the number of pills left in the bottle as a way to ensure you're taking your pills on time.
Additional ways to keep up with your medication schedule and control your high blood pressure (or any chronic condition that requires prescription
meds):
Set up text message alerts. Add these on your phone, to remind you to take your medication as prescribed.
Use an alarm. Use an alarm on your phone, computer or pager - any device that you always have with you.
Invest in a medical watch. One with alarms and text can remind you of the drugs and doses you need to take.
Try an automatic pill dispenser. These electronic gadgets keep up to 14 days of medication locked up until needed, then at the right time,
dispense the right amount into a cup.
Look into one of the new electronic pill timer bottle caps. These go on top of a medication bottle and include an alarm and a "last opened"
timer showing the day and time meds were last taken.
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Dr. Sanjay Gupta: How do I know if my child is dyslexic?
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This article originally appeared on EverydayHealth.com: 1 in 4 Don't Take High Blood Pressure Meds Correctly: Do You?

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