As many as half of "failures" of treatment to bring elevated blood pressure down to normal levels may be due to unrecognized lapses by patients in taking antihypertensive drugs as prescribed, according to a new study by a team of researchers from the University of Lausanne, Switzerland.
In general, says the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, pharmacological therapy for uncontrolled blood pressure should proceed in stepwise fashion. The physician usually prescribes a low dosage of a diuretic or β-blocker, moves to higher dosages if blood pressure remains uncontrolled, and then—if no response is seen—substitutes or adds a drug from another class. The guidelines also urge physicians to be willing to stop unsuccessful therapy and try a different approach.
Stephenson J. Noncompliance May Cause Half of Antihypertensive Drug "Failures". JAMA. 1999;282(4):313-314. doi:10.1001/jama.282.4.313