Medication Adherence and "True" Resistance in Patients With Resistant Hypertension

A Study on Medication Adherence and "True" Resistance in Patients Referred to a Medical Outpatient Department in Germany With the Diagnosis "Resistant Hypertension".

The purpose of this study is to estimate the proportion of patients with "true" resistance among patients referred to the Medical Outpatient Department of the Charité - Universitätsmedizin Berlin with the diagnosis "resistant hypertension". Moreover, data on medication adherence will be collected based on therapeutic drug monitoring and on the answers to validated questionnaires. Finally, efficacy, safety and costs of renal sympathetic denervation will be compared to an intensified drug treatment in an exploratory way.

Inclusion Criteria:

• Female or male adult patients with arterial hypertension and admission diagnosis of "resistant hypertension"
• Informed consent
• Exclusion of secondary arterial hypertension
• Kidney function (estimated glomerular filtration rate [eGFR] ≥ 45 ml/min/1.73 m2)

Exclusion Criteria:

• Age < 18 years
• Secondary arterial hypertension
• Type 1 Diabetes mellitus
• Unstable coronary heart disease, myocardial infarction or stroke in the last 6 months
• Psychiatric diseases
• Significant carotid stenosis (> 70%)
• Pregnancy
• Chronic kidney disease (eGFR < 45 ml/min/1.73 m2)
• Severe liver injury (elevation of transaminases more than twofold the upper limit of normal)
• Abuse of alcohol or illegal drugs