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To explore nonadherence in treatment of hypertension, Canadian researchers recruited 48 patients whose blood pressure (BP) was not controlled adequately (mean systolic BP, ≥135 mm Hg on 24-hour ambulatory BP monitoring [ABPM]) despite receiving three or more antihypertensive medications. All patients had to be completely adherent with treatment based on questionnaires, prescription refill records, and pill counts. Patients were then observed on 1 day by a nurse who administered all prescribed antihypertensive medications, followed by BP monitoring until the peak effect of medication was demonstrated and then 24-hour ABPM. The patients also underwent 24-hour ABPM 1 month later.
Thirty-four of the 48 patients (71%) showed essentially no change…