Eva Kociánová1, Jan Václavík1, Jana Tomková2, Peter Ondra2, Jiří Jarkovský3, Klára Benešová3, Tomáš Václavík4, Monika Kamasová1, Miloš Táborský1. 1. a Department of Internal Medicine I-Cardiology, Faculty of Medicine and Dentistry , Palacky University Olomouc and University Hospital Olomouc , Olomouc , Czech Republic. 2. b Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry , Palacky University , Olomouc , Czech Republic. 3. c Faculty of Medicine, Faculty of Science , Institute of Biostatistics and Analyses, Masaryk University , Brno , Czech Republic. 4. d Department of Statistics and Probability, Faculty of Informatics and Statistics , University of Economics , Prague , Czech Republic.
Abstract
OBJECTIVES: Suboptimal medication adherence is common among patients with hypertension. Measurements of plasma or urinary levels of antihypertensive drugs are useful, but not widely available. The aim of our study was to investigate the relation of patients' heart rates to their serum beta-blocker levels. METHODS: We correlated 220 measurements of serum beta-blocker levels in 106 patients with apparently resistant hypertension to their corresponding office heart rate. A significant proportion, 44.6% of patients, were non-adherent to beta-blocker treatment according to serum level measurement. Non-adherent patients had significantly higher heart rates (80.9 vs. 66.6 bpm, p < .001), systolic (157.4 vs. 147.0 mm Hg, p = .002) and diastolic blood pressure (91.1 vs. 87.2 mm Hg, p = .041) in comparison to adherent patients. RESULTS: Heart rate above 75.5 beats per minute predicted non-adherence to beta-blocker treatment with a sensitivity of 62.5%, specificity 86.8% and AUC ROC 0.802 (p < .001). Higher heart rate cutoff might be applicable for nebivolol but was not determined due to the low number of patients treated with nebivolol. CONCLUSIONS: We concluded that heart rate was shown to be a good predictor of non-adherence to beta-blocker treatment, and might become a quick and easy measure to determine patient adherence in hypertensive patients.
OBJECTIVES: Suboptimal medication adherence is common among patients with hypertension. Measurements of plasma or urinary levels of antihypertensive drugs are useful, but not widely available. The aim of our study was to investigate the relation of patients' heart rates to their serum beta-blocker levels. METHODS: We correlated 220 measurements of serum beta-blocker levels in 106 patients with apparently resistant hypertension to their corresponding office heart rate. A significant proportion, 44.6% of patients, were non-adherent to beta-blocker treatment according to serum level measurement. Non-adherent patients had significantly higher heart rates (80.9 vs. 66.6 bpm, p < .001), systolic (157.4 vs. 147.0 mm Hg, p = .002) and diastolic blood pressure (91.1 vs. 87.2 mm Hg, p = .041) in comparison to adherent patients. RESULTS: Heart rate above 75.5 beats per minute predicted non-adherence to beta-blocker treatment with a sensitivity of 62.5%, specificity 86.8% and AUC ROC 0.802 (p < .001). Higher heart rate cutoff might be applicable for nebivolol but was not determined due to the low number of patients treated with nebivolol. CONCLUSIONS: We concluded that heart rate was shown to be a good predictor of non-adherence to beta-blocker treatment, and might become a quick and easy measure to determine patient adherence in hypertensivepatients.
Entities:
Keywords:
Adherence; beta blockers; compliance; drug level monitoring; resistant hypertension
Authors: 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 Journal: Integr Blood Press Control Date: 2021-02-11