Client-centered drug choice: an alternative approach in managing hypertension

Despite adequate pharmacological alternatives, only a minority of individuals living with hypertension achieve normotensive blood-pressure levels. Numerous medical and behavioral strategies have been implemented in an attempt to increase adherence to therapeutic regimens. Most of these techniques have resulted in short-term adherence improvement and a high degree of relapse in the period following experimentation, making assessment of potential long-term benefits of therapy impossible. Regardless of the strategy selected, active patient participation has been consistently identified as a critical element in improving adherence. This article describes a new pharmacological management strategy for individuals with mild hypertension. This strategy allows individuals to sample different antihypertensive medications for a period of four weeks to six weeks and select their preferred drug of choice for hypertension management based on the individuals' subjective responses to therapy. When used with different beta blockers, this management approach has provided effective control of mild hypertension and has kept clients in therapy when other strategies have failed.