As many as 25% of people prescribed drugs for high blood pressure do not take their medicines properly, researchers warn today.
And many patients whose blood pressure appears not to be responding to treatment may be among these, according to a new study.
The findings come from a specialist hypertension clinic, where doctors decided to find out more about patients whose blood pressure seemed hard to treat.
They tested urine samples from more than 200 patients and found that 10% were not taking the drugs they had been prescribed.
And another 15% were found to be taking drugs incompletely.
Reporting in the journal Heart, the researchers say the greatest level of non-compliance was among patients referred for a major procedure, renal denervation.
Researcher Dr Maciej Tomaszewski, of Leicester University, UK, says there were "alarmingly high levels” of patients not taking their drugs.
He writes: "A majority of these patients in any secondary/tertiary care centre would routinely undergo many additional tests and procedures in search of the explanation for their apparent unresponsiveness to standard therapy prescribed in primary care."
Writing in the journal Professor Morris Brown, of Cambridge University, says doctors should use urine testing more often as it could "solve at a stroke the problem of monitoring adherence and should rapidly transform practice."
He added: "That most patients do not take all their drugs all the time was probably predictable. But that 23% of those referred for renal denervation have no detectable drug in their urine was a shock."
High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis Heart 3 April 2014; doi: 10.1136/heartjnl-2013-305063 [abstract]
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