| dc.contributor.advisor | Wallbach, Manuel PD Dr. | |
| dc.contributor.author | Lach, Nadine | |
| dc.date.accessioned | 2021-05-20T13:57:19Z | |
| dc.date.available | 2021-06-03T00:50:11Z | |
| dc.date.issued | 2021-05-20 | |
| dc.identifier.uri | http://hdl.handle.net/21.11130/00-1735-0000-0008-582E-3 | |
| dc.identifier.uri | http://dx.doi.org/10.53846/goediss-8605 | |
| dc.identifier.uri | http://dx.doi.org/10.53846/goediss-8605 | |
| dc.language.iso | deu | de |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
| dc.subject.ddc | 610 | de |
| dc.title | Therapieadhärenz und Arzneimittelwechselwirkungen bei Patienten mit hypertensiver Krise | de |
| dc.type | doctoralThesis | de |
| dc.title.translated | Adherence and drug interactions in patients with hypertensive crisis | de |
| dc.contributor.referee | Herrmann-Lingen, Christoph Prof. Dr. | |
| dc.date.examination | 2021-05-27 | |
| dc.description.abstracteng | Based on retrospective data and indirect adherence measurements, limited drug adherence is assumed to be a significant factor for the occurrence of hypertensive crisis (HTN-C). Data from direct adherence measurements were not available at the start of the study. The aim of the present study was to determine the degree of adherence to the prescribed antihypertensive drugs and the possible interactions of concomitant medication and food with the prescribed antihypertensive drugs in patients with HTN-C using a direct biochemical urine analysis. In this cross-sectional study 100 consecutive patients with HTN-C (systolic blood pressure ≥ 180 mmHg and / or diastolic blood pressure ≥ 120 mmHg), who were admitted to the emergency department of the University Medical Center Göttingen, were included. A biochemical urine analysis was carried out for the presence of antihypertensive drugs and concomitant medication or substances using a GC-coupled MS. Of 100 patients, 86 (86%) were treated with antihypertensive drugs. The urine analysis data could be clearly evaluated in a total of 62 patients. Complete non-adherence (no prescribed antihypertensive agent detectable) could be detected in 15 of these 62 patients (24%). A partial non-adherence (at least one antihypertensive agent undetectable) was observed in 21 patients (34%). Patients with non-adherence or partial non-adherence had a longer history of HTN (15 [5-22] vs. 10 [3-15] years; p = 0.04) and were prescribed more antihypertensive drugs (number 2.8 ± 1.1 vs. 1.5 ± 0.7; p <0.01) and had a higher total number of drugs (7.1 ± 3.4 vs. 3.4 ± 1.8; p <0.01). Potential concomitant drugs or substances that increase blood pressure were often detectable: NSAIDs (n = 33), glucocorticoids (n = 8), antidepressants (n = 10), caffeine (n = 92), nicotine (n = 20) and licorice (n = 10, surveyed). Non-adherence and partial non-adherence to the prescribed antihypertensive drugs could play a decisive role in the occurrence of HTN-C. However, case-controlled studies are needed to confirm the present results. Simultaneous use of over-the-counter drugs such as NSAIDs, but also prescribed drugs and food, could also contribute to a critical increase in blood pressure. In order to prevent the occurrence of HTN-C and the associated end-organ damage and to initiate adequate treatment in patients who have already entered HTN-C, it is important for the treating physicians to consider restricted adherence and potentially hypertensive concomitant medication as a potential cause of the critical blood pressure increase. | de |
| dc.contributor.coReferee | Meyer, Thomas Prof. Dr. | |
| dc.subject.eng | Arterial hypertension | de |
| dc.subject.eng | Hypertensive crisis | de |
| dc.subject.eng | Adherence | de |
| dc.subject.eng | Drug interactions | de |
| dc.subject.eng | Gas-chromatography Mass Spectrometry | de |
| dc.identifier.urn | urn:nbn:de:gbv:7-21.11130/00-1735-0000-0008-582E-3-6 | |
| dc.affiliation.institute | Medizinische Fakultät | de |
| dc.subject.gokfull | Medizin (PPN619874732) | de |
| dc.subject.gokfull | Innere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747) | de |
| dc.subject.gokfull | Nephrologie (PPN619875828) | de |
| dc.description.embargoed | 2021-06-03 | |
| dc.identifier.ppn | 1758307161 | |