Urine test detects treatment nonadherence in hypertensives

A urine test may be an effective tool to detect nonadherence to blood pressure therapy, according to a study published online April 2 in Heart.

Researchers led by Maciej Tomaszewski, MD, of the University of Leicester in Leicester, UK, used high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) to assess the antihypertensive medications of 208 participants during clinical appointments. The test screened for 40 of the most commonly used antihypertensives.

One-fourth of the participants were completely or partially nonadherent to antihypertensive treatment (total nonadherence was 10.1 percent and partial nonadherence was 14.9 percent). Patients with poorly controlled hypertension (28.8 percent) and patients under consideration for renal denervation (23.5 percent) were most often partially or totally nonadherent.

They also found that systolic blood pressure and diastolic blood pressure measured in the clinic and 24-hour average daytime blood pressure were higher in partially or totally nonadherent patients.

Renal denervation, the researchers explained, is sometimes considered for nonadherent patients, but they added that the procedure is costly and unproven.

The authors acknowledged that larger studies should be conducted to assess other populations as well as the cost-effectiveness of this screening. However, they argued that their study suggests this type of screening “is a simple, noninvasive diagnostic test with a potential to better stratify patients prior to treatment escalations and expensive and irreversible procedures such as renal denervation.”