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Apparent treatment hypertension in general practice: systematic review of prognosis and impact of ABPM variability on medication adherence

Treatment resistant hypertension means high blood pressure which is not being reduced by three or more medications, one of which is a water tablet. The high blood pressure cannot be caused by the stress of visiting the doctor, the medications being weak nor a failure to take the medication. But it is really difficult to work all these things out. Most studies simply count the number of tablets and look at the blood pressure level ignoring these other things. We think these patients are at much higher risk of having a stroke, heart attack or even death, but nobody knows.
In this study, we will read and put together all the world research that has followed such patients over time and work out what are the real risks of having a stroke, heart attack or dying. With the help of the Health Research Board, we have identified 208 patients from fifteen general practices with apparent treatment resistant hypertension. They have all undergone 24 hour assessments of their blood pressure (ABPM) and many psychological tests focusing on taking their medications. Also, and most unusually, their urine has been examined to see if they are actually taking the medications. We will look and see what is the relationship between their blood pressure readings and their medication taking.
To tell others about these two pieces of research, we will write two papers and talk at national and international conferences.