Drug Adherence in Resistant Hypertension

  • Idir Hamdidouche
  • Vincent Jullien
  • Stéphane Laurent
  • Michel AziziEmail author
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)


Non-adherence to antihypertensive treatment is recognized as a major factor affecting their effectiveness in hypertensive patients contributing to treatment resistance. Indeed, non-adherence is highly prevalent in patients with resistant hypertension. However, it is often overlooked because the methods to assess non-adherence are partly unreliable and thus limit their use in clinical practice. Non-adherence to treatment can affect daily patient management, resulting in inappropriate, costly, and potentially harmful treatment and loss of benefits expected from antihypertensive drugs. Indeed, non-adherence is associated with poor cardiovascular, cerebrovascular, and renal outcomes. Thus, improved screening tools, including therapeutic drug monitoring, are needed to detect non-adherence in patients with resistant hypertension, thus enabling appropriate interventions to improve drug adherence and avoid unnecessary treatment intensification. Given the expanding population with uncontrolled and resistant hypertension and emerging cost–benefits of adherence, addressing non-adherence to prescribed antihypertensive therapy is a top priority.


Resistant hypertension Antihypertensive drugs Drug adherence Therapeutic drug monitoring Cardiovascular outcomes 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Idir Hamdidouche
    • 1
    • 2
    • 3
  • Vincent Jullien
    • 1
    • 2
  • Stéphane Laurent
    • 1
    • 2
    • 3
  • Michel Azizi
    • 1
    • 2
    • 4
    Email author
  1. 1.Department of Pharmacology and Hypertension UnitHopital Europeen Georges Pompidou, Assistance-Publique Hopitaux de ParisParisFrance
  2. 2.Paris-Descartes UniversityParisFrance
  3. 3.INSERM UMRS970ParisFrance
  4. 4.INSERM CIC1418ParisFrance

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