PS-C33-9: PSYCHOLOGICAL ABNORMALITIES IN PATIENTS WITH RESISTANT HYPERTENSION FOUND NON-ADHERENT BY DIRECTLY OBSERVED TREATMENT INTAKE

Abstract

Introduction & aim: We intend to assess the underlying psychological and behavioural factors in patients with resistant hypertension (HTres) confirmed as non-adherents by directly observed treatment intake (DOTI). Methods: We studied with DOTI 68 patients with HTres in outpatient hypertension clinic. 24-h ambulatory BP (ABP) was evaluated before the procedure. In DOTI patients took all medications in the morning for 5 days under the supervision of a technician and performing on the fifth day a second ABP. In some patients a third ABP measurement was repeated 3–6 months after DOTI. All patients responded to appropriate questionnaires evaluating their psychological and behavioural profiles Results: Out of the 68 patients 76% were female and 21% diabetics in average ageing 62 years and BMI 30 Kg/m2. Average antihypertensive agents was 4.6 ± 1.2 drugs/day. After DOTI casual, daytime and night-time BP decreased significantly (24 h from 149/82 + 13/13 to 131/74 + 13/9 mm Hg, p < 0.01). Pts (n = 36, i.e. 52.9%) were classified as non-adherents (false HTres) since after DOTI vs previous 24-h ABP there was a significant reduction of mean 24 h BP to < 130/80 mm Hg or a reduction of both 24 h SBP and 24 h DBP by > 10%). Non-adherents i.e false HTres showed significant worse values of disbelief in the potential benefits of treatment, expression of emotions, hostility, anxiety, paranoid ideation, self-blame, physical mobility, smoking habits and social isolation. Conclusions: DOTI can be a valuable tool to identify the non-adherence to therapy as a cause of HRes. Non-adherence was associate with worse psychological and behaviour profiles.