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Review
. 2024 Aug;90(8):1884-1891.
doi: 10.1111/bcp.16125. Epub 2024 Jun 7.

'Under pressure': The role of therapeutic drug monitoring in the treatment of hypertension

Jorie Versmissen  1   2 , Job van Steenkiste  1   3   4 , Birgit C P Koch  1 , Laura E J Peeters  1   5
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Free article
Review

'Under pressure': The role of therapeutic drug monitoring in the treatment of hypertension

Jorie Versmissen et al. Br J Clin Pharmacol. 2024 Aug.
Free article

Abstract

Antihypertensive drugs do not qualify as optimal candidates for therapeutic drug monitoring (TDM), given their obvious physiological effect, the absence of a clear relationship between drug concentrations and pharmacodynamic outcomes and their wide therapeutic range. However, since non-adherence is a major challenge in hypertension management, using drug concentrations can be of value to identify non-adherence as a first step towards better blood pressure control. In this article we discuss the key challenges associated with measuring and interpreting antihypertensive drug concentrations that are important when TDM is used to improve non-adherence. Additionally, we elaborate on the role of TDM in optimizing antihypertensive drug treatment besides addressing non-adherence by highlighting its value in specific patient groups with altered pharmacokinetic parameters such as female vs. male or elderly patients.

Keywords: adherence; antihypertensive drugs; hypertension; therapeutic drug monitoring.

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