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Related Experiment Videos

Intermittent blood pressure control: potential consequences for outcome.

F H Leenen1

  • 1Hypertension Unit, University of Ottawa Heart Institute, Ontario. fleenen@ottawaheart.ca

The Canadian Journal of Cardiology
|June 25, 1999
PubMed
Summary

Intermittent compliance with hypertension medications can lead to uncontrolled blood pressure and increased cardiovascular risk. Drugs with slow onset and long duration of action offer more consistent blood pressure control and fewer risks with missed doses.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Blood pressure (BP) and left ventricular (LV) mass predict cardiovascular risk.
  • Achieved BP and LV mass during treatment correlate more strongly with cardiovascular event rates.
  • Intermittent medication compliance is a primary cause of uncontrolled hypertension and persistent LV hypertrophy.

Purpose of the Study:

  • To evaluate the impact of intermittent compliance with antihypertensive drugs on cardiovascular risk.
  • To compare the effects of different drug classes with varying onset and duration of action on BP control and adverse events.

Main Methods:

  • Review of existing literature on antihypertensive drug pharmacokinetics and pharmacodynamics.
  • Analysis of the relationship between drug properties (onset, duration), compliance patterns, and clinical outcomes.

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  • Categorization of antihypertensive drug classes based on their suitability for intermittent dosing.

    • Main Results:

    • Drugs with rapid onset and short duration may cause significant BP fluctuations and increase adverse event risk, especially with missed doses.
    • Short-acting drugs like dihydropyridines can lead to intermittent BP control and sympathetic activation.
    • Diuretics, ACE inhibitors, and ARBs appear to have no identified adverse effects with intermittent compliance.

    Conclusions:

    • Intermittent BP control is generally not advisable for hypertension management due to increased risks.
    • Drugs with slow onset and long duration of action provide more consistent BP control and mitigate risks associated with noncompliance.
    • Tailoring antihypertensive therapy based on drug properties and patient compliance is crucial for optimizing cardiovascular outcomes.