Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids
Background It is currently unknown if antihypertensive drugs can be monitored in oral fluid (OF) using liquid chromatography coupled to high‐resolution mass spectrometry. Methods and Results We assessed adherence using liquid chromatography coupled to high‐resolution mass spectrometry in OF, plasma,...
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014180 |
| _version_ | 1819175144366538752 |
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| author | Lucas Lauder Sebastian Ewen Michael Kunz Lilian H. J. Richter Cathy M. Jacobs Ingrid Kindermann Michael Böhm Markus R. Meyer Felix Mahfoud |
| author_facet | Lucas Lauder Sebastian Ewen Michael Kunz Lilian H. J. Richter Cathy M. Jacobs Ingrid Kindermann Michael Böhm Markus R. Meyer Felix Mahfoud |
| author_sort | Lucas Lauder |
| collection | DOAJ |
| description | Background It is currently unknown if antihypertensive drugs can be monitored in oral fluid (OF) using liquid chromatography coupled to high‐resolution mass spectrometry. Methods and Results We assessed adherence using liquid chromatography coupled to high‐resolution mass spectrometry in OF, plasma, and urine of 56 consecutive patients with hypertension referred to a tertiary hypertension unit. Of these patients, 59% were completely adherent (all drugs detectable in urine), whereas 29% and 13% were partially adherent (1 drug not detectable in urine) or nonadherent (>1 drug not detectable in urine), respectively. Adherent patients were on fewer antihypertensive drugs (P=0.001), had fewer daily drug doses (P=0.012), and had lower 24‐hour ambulatory systolic (P=0.012) and diastolic (P=0.009) blood pressures than nonadherent or partially adherent patients. Most drugs were detected in urine compared with plasma and OF (181 versus 119 versus 88; P=0.001). Compared with urine and plasma, detection rates of angiotensin‐converting enzyme inhibitors, angiotensin II receptor blockers, and diuretics were lower in OF. There was no difference in the frequency of detecting β blockers (P=1.0) and calcium channel blockers (P=0.063) when comparing OF with urine. There was no difference in the number of calcium channel blockers (P=0.727), β blockers (P=1.000), thiazide diuretics (P=0.125), and α‐2 agonists (P=0.125) identified between OF and plasma. Conclusions This study shows the feasibility of drug adherence testing for several antihypertensive drugs, especially those without acidic components, in OF, with a similar recovery compared with plasma. Therefore, drug adherence testing in OF should be further explored as a noninvasive approach, which can easily be performed in an “out‐of‐office” setting. |
| first_indexed | 2024-12-22T20:50:12Z |
| format | Article |
| id | doaj.art-2a81e0b2a1644afb8a2a49712db72764 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T20:50:12Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-2a81e0b2a1644afb8a2a49712db727642022-12-21T18:13:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-07-0191410.1161/JAHA.119.014180Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral FluidsLucas Lauder0Sebastian Ewen1Michael Kunz2Lilian H. J. Richter3Cathy M. Jacobs4Ingrid Kindermann5Michael Böhm6Markus R. Meyer7Felix Mahfoud8Klinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyKlinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyKlinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyDepartment of Experimental and Clinical Toxicology Institute of Experimental and Clinical Pharmacology and Toxicology Center for Molecular Signaling Saarland University Homburg/Saar GermanyDepartment of Experimental and Clinical Toxicology Institute of Experimental and Clinical Pharmacology and Toxicology Center for Molecular Signaling Saarland University Homburg/Saar GermanyKlinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyKlinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyDepartment of Experimental and Clinical Toxicology Institute of Experimental and Clinical Pharmacology and Toxicology Center for Molecular Signaling Saarland University Homburg/Saar GermanyKlinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin Universitätsklinikum des Saarlandes and Saarland University Homburg/Saar GermanyBackground It is currently unknown if antihypertensive drugs can be monitored in oral fluid (OF) using liquid chromatography coupled to high‐resolution mass spectrometry. Methods and Results We assessed adherence using liquid chromatography coupled to high‐resolution mass spectrometry in OF, plasma, and urine of 56 consecutive patients with hypertension referred to a tertiary hypertension unit. Of these patients, 59% were completely adherent (all drugs detectable in urine), whereas 29% and 13% were partially adherent (1 drug not detectable in urine) or nonadherent (>1 drug not detectable in urine), respectively. Adherent patients were on fewer antihypertensive drugs (P=0.001), had fewer daily drug doses (P=0.012), and had lower 24‐hour ambulatory systolic (P=0.012) and diastolic (P=0.009) blood pressures than nonadherent or partially adherent patients. Most drugs were detected in urine compared with plasma and OF (181 versus 119 versus 88; P=0.001). Compared with urine and plasma, detection rates of angiotensin‐converting enzyme inhibitors, angiotensin II receptor blockers, and diuretics were lower in OF. There was no difference in the frequency of detecting β blockers (P=1.0) and calcium channel blockers (P=0.063) when comparing OF with urine. There was no difference in the number of calcium channel blockers (P=0.727), β blockers (P=1.000), thiazide diuretics (P=0.125), and α‐2 agonists (P=0.125) identified between OF and plasma. Conclusions This study shows the feasibility of drug adherence testing for several antihypertensive drugs, especially those without acidic components, in OF, with a similar recovery compared with plasma. Therefore, drug adherence testing in OF should be further explored as a noninvasive approach, which can easily be performed in an “out‐of‐office” setting.https://www.ahajournals.org/doi/10.1161/JAHA.119.014180adherencearterial hypertensioncomplianceliquid chromatography coupled to high‐resolution mass spectrometrytoxicological analyses |
| spellingShingle | Lucas Lauder Sebastian Ewen Michael Kunz Lilian H. J. Richter Cathy M. Jacobs Ingrid Kindermann Michael Böhm Markus R. Meyer Felix Mahfoud Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adherence arterial hypertension compliance liquid chromatography coupled to high‐resolution mass spectrometry toxicological analyses |
| title | Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids |
| title_full | Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids |
| title_fullStr | Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids |
| title_full_unstemmed | Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids |
| title_short | Adherence to Antihypertensive Drugs Assessed by Hyphenated High‐Resolution Mass Spectrometry Analysis of Oral Fluids |
| title_sort | adherence to antihypertensive drugs assessed by hyphenated high resolution mass spectrometry analysis of oral fluids |
| topic | adherence arterial hypertension compliance liquid chromatography coupled to high‐resolution mass spectrometry toxicological analyses |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014180 |
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