Directly observed therapy to assess adherence in patient with apparent refractory hypertension. A case-report

Refractory arterial hypertension (RefHTN) is an extreme phenotype of resistant hypertension (RHTN), is associated with utmost poor clinical sequelae. True RHTN occurs in 10-15 % of treated patients. Up to half of them meet the definition of RefHTN, but another ~50 % are eventually diagnosed with ‘pseudo’-RHTN. Partial or complete non-adherence are among its the main causes. To date, there is no ‘gold’ standard to assess adherence. Directly observed therapy (DOT) is a promising non-invasive method to assess patient compliance. The wellknown abroad, DOT is not widely used in Russian clinical practice. In this short report we demonstrate a case of DOT in a patient with apparent RefHTN.