Quantifying adherence to antihypertensive medication for chronic hypertension during pregnancy

Pregnancy Hypertens. 2019 Jul:17:12-14. doi: 10.1016/j.preghy.2019.05.004. Epub 2019 May 3.

Abstract

Estimates of adherence to antihypertensive treatment in pregnancy are limited; identifying non-adherence could facilitate intervention and optimise blood pressure control. This study aimed to evaluate adherence to antihypertensive treatment amongst pregnant women with chronic hypertension using high-performance liquid chromatography-tandem mass spectrometry instrumentation. Spot urine samples collected from women who were randomised to labetalol or nifedipine were assessed. Samples from 74 women were included; documented prescribing and urine metabolite detection were concordant in 88% (n = 65). Evidence of self-administration of alternative treatment was observed in 8% (n = 6). Measurement of urinary antihypertensive metabolites in pregnancy provides insight into treatment adherence.

Keywords: Adherence; Antihypertensive treatment; Chronic Hypertension; Pregnancy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Determination
  • Chromatography, High Pressure Liquid
  • Cohort Studies
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / urine
  • Labetalol / administration & dosage
  • Labetalol / therapeutic use
  • Medication Adherence*
  • Nifedipine / administration & dosage
  • Nifedipine / therapeutic use
  • Pre-Eclampsia / prevention & control*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Prenatal Care*
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Nifedipine
  • Labetalol