Predictors of blood pressure control in patients with resistant hypertension after intensive management in two expert centres: the Brussels-Torino experience

Pappaccogli, Marco; Monaco, Silvia Di; Georges, Coralie; Petit, Géraldine; Eula, Elisabetta; Ritscher, Sabrina; Lengelé, Jean-Philippe; Fanelli, Elvira; Severino, Francesca; Renkin, Jean; Avataneo, Valeria; Wallemacq, Pierre; Toennes, Stefan W.; Timary, Philippe de; Rabbia, Franco; Persu, Alexandre

doi:10.1080/08037051.2019.1633908

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…As demonstrated in previous studies [11,12], patients with hypertension are more likely to develop anxiety or psychological distress, showing an increased difficulty to describe feelings and adjust expression of emotion in stressful situations [13]. These negative feelings, enhanced by lockdown, self-isolation, family and personal problems, as well as by the psychological distress related to the own or relative's health, may have contributed to worsen BP status.…”

Section: Social Distancing and Family Problemsmentioning

confidence: 78%

Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic

Kreutz

Dobrowolski

Prejbisz

et al. 2020

Journal of Hypertension

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The coronavirus disease 2019 (COVID-19) pandemic considerably affects health, wellbeing, social, economic and other aspects of daily life. The impact of COVID-19 on blood pressure (BP) control and hypertension remains insufficiently explored. We therefore provide a comprehensive review of the potential changes in lifestyle factors and behaviours as well as environmental changes likely to influence BP control and cardiovascular risk during the pandemic. This includes the impact on physical activity, dietary patterns, alcohol consumption and the resulting consequences, for example increases in body weight. Other risk factors for increases in BP and cardiovascular risk such as smoking, emotional/psychologic stress, changes in sleep patterns and diurnal rhythms may also exhibit significant changes in addition to novel factors such as air pollution and environmental noise. We also highlight potential preventive measures to improve BP control because hypertension is the leading preventable risk factor for worldwide health during and beyond the COVID-19 pandemic.

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Section: Social Distancing and Family Problemsmentioning

confidence: 78%

Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic

Kreutz

Dobrowolski

Prejbisz

et al. 2020

Journal of Hypertension

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“…Literature shows that psychological characteristics, such as the ability to modify the emotional impact of stressful situations might also influence blood pressure control. 45 Besides, past traumatic experiences and related stress are also related to low levels of adherence. 46 47 As discussed in our focus groups, healthcare providers should pay attention to social problems and stress during the conversation with a patient and be aware of the context in which patients develop hypertension.…”

Section: Discussionmentioning

confidence: 99%

Opinions on hypertension care and therapy adherence at the healthcare provider and healthcare system level: a qualitative study in the Hague, Netherlands

et al. 2022

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ObjectivesHypertension is a common cause of cardiovascular morbidity and mortality. Although hypertension can be effectively controlled by blood pressure-lowering drugs, uncontrolled blood pressure is common despite use of these medications. One explanation is therapy non-adherence. Therapy non-adherence can be addressed at the individual level, the level of the healthcare provider and at the healthcare system level. Since the latter two levels are often overlooked, we wished to explore facilitators and barriers on each of these levels in relation to hypertension care for people with hypertension, with a specific focus on therapy adherence.DesignQualitative study using focus groups of healthcare providers. Data were analysed using the theoretical domains framework (TDF) and the behaviour change wheel.Setting and participantsParticipants were from a highly urbanised city environment (the Hague, Netherlands), and included nine primary care physicians, six practice nurses and five secondary care physicians involved in hypertension care.ResultsNine domains on the TDF were found to be relevant at the healthcare provider level (‘knowledge’, ‘physical, cognitive and interpersonal skills’, ‘memory, attention and decision processes’, ‘professional, social role and identity’, ‘optimism’, ‘beliefs about consequences’, ‘intention’, ‘emotion’ and ‘social influences’) and two domains (‘resources’ and ‘goals’) were found to be relevant at the system level. Facilitators for these domains were good interpersonal skills, paying attention to behavioural factors such as medication use, and the belief that treatment improves health outcomes. Barriers were related to time, interdisciplinary collaboration, technical and financial issues, availability of blood pressure devices and education of people with hypertension.ConclusionsThis study highlighted a need for better collaboration between primary and secondary care, for more team-based care including pharmacists and social workers, tools to improve interpersonal skills and more time for patient–healthcare provider communication.

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“…8,10,11 Our group has demonstrated that about 86% have presented poor adherence to both medication and nonmedication treatment, and emotional factors were the most reported (69.12%) among patients' reasons for nonadherence to treatment 36 a fact also observed in two European centers, which demonstrated that emotional impact was an important predictor of BP control. 37 Several methods are used for assessment of adherence to BP-lowering drugs, but they have different degrees of accuracy. Figure 2 shows the indirect (noninvasive) and direct (invasive) methods used for evaluation of adherence to antihypertensive drugs.…”

Section: Discussionmentioning

confidence: 99%

Evidence of Nonadherence in Cases of Pseudoresistant Hypertension

Zanatta¹,

Cosenso-Martin²,

Lopes³

et al. 2021

IBPC

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Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.

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Predictors of blood pressure control in patients with resistant hypertension after intensive management in two expert centres: the Brussels-Torino experience

Cited by 9 publications

References 26 publications

Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic

Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic

Opinions on hypertension care and therapy adherence at the healthcare provider and healthcare system level: a qualitative study in the Hague, Netherlands

Evidence of Nonadherence in Cases of Pseudoresistant Hypertension

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