Heart Rate Variability and Medication Adherence in Resistant Hypertension
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Heart rate variability recording (Polar H10) ·, Therapeutic drug monitoring (antihypertensive drug levels), Questionnaires (MARS-CZ, PHQ-9, SF-36, IPAQ).
- Who it may be relevant to
- Registry conditions: Resistant Hypertension, Medication Adherence, Autonomic Nervous System. Basic parameters: 18 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Czechia
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Eart Rate Variability, Medication Adherence, and Blood Pressure Control in Resistant Hypertension: A Cross-Sectional Study
Overview
This single-center, cross-sectional observational study examines the relationship between adherence to antihypertensive therapy - verified objectively by therapeutic drug monitoring (TDM) - and heart rate variability (HRV) in patients with resistant hypertension. Patients are recruited opportunistically, in a nurse-led manner, in a one-day-care cardiology unit, and undergo a single examination: a short-term HRV recording (Polar H10), a single blood draw for antihypertensive drug levels, office blood pressure, and self-completed questionnaires. There is no follow-up.
Detailed description
Non-adherence to antihypertensive medication is a major cause of apparently resistant hypertension and confounds interpretation of autonomic measures. HRV is a non-invasive index of autonomic cardiac regulation and is systematically influenced by antihypertensive drugs. The study tests whether TDM-verified intake of antihypertensives is reflected in HRV parameters, and whether HRV can serve as a complementary marker of adherence. Adherence is determined by TDM (the objective gold standard); a self-report questionnaire (MARS-CZ) is collected as a secondary, descriptive measure. HRV is recorded for 10-15 minutes seated, before sedation and before heparin/contrast; the blood sample is drawn before heparin/contrast, with the time of last dose recorded. Time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF) HRV parameters are analysed. Approximately 100-200 patients are planned for enrolment. It does not interfere with the patient's planned cardiac procedure; the one-day-care unit is the recruitment venue only.
Interventions
- Diagnostic test Heart rate variability recording (Polar H10) ·
Short-term (10-15 min) seated HRV; time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF) parameters. - Diagnostic test Therapeutic drug monitoring (antihypertensive drug levels)
Single blood draw measuring antihypertensive drug levels; defines adherent vs non-adherent status. - Other Questionnaires (MARS-CZ, PHQ-9, SF-36, IPAQ)
Self-completed instruments assessing medication adherence, mood, quality of life, and physical activity.
Primary outcome measures
- Heart rate variability parameters by TDM-defined adherence [Time frame: At the single study visit (Day 1)]
Secondary outcome measures (3)
- Heart rate variability in relation to office blood-pressure control [Time frame: At the single study visit (Day 1)]
- Questionnaire scores in relation to adherence and HRV [Time frame: At the single study visit (Day 1)]
- Prevalence of non-adherence by therapeutic drug monitoring [Time frame: At the single study visit (Day 1)]
Eligibility criteria
Inclusion criteria
- Age 18-75 years with diagnosed essential hypertension
- Treated with ≥3 antihypertensive drugs of different classes, including ≥1 diuretic (resistant hypertension)
- Sinus rhythm
- Able to give informed consent and understand Czech
Exclusion criteria
- Absence of sinus rhythm: atrial fibrillation/flutter, ventricular arrhythmias, higher-degree AV block, pacemaker/ICD with sustained pacing, sustained SVT, or significant ectopy
- Secondary hypertension
- Pregnancy or breastfeeding
- Cognitive impairment precluding informed consent
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Czechia · 1 center
- Nemocnice AGEL Třinec-Podlesí a.s. — Třinec
Publications
- Ladova K, Matoulkova P, Zadak Z, Macek K, Vyroubal P, Vlcek J, Morisky DE. Self-reported adherence by MARS-CZ reflects LDL cholesterol goal achievement among statin users: validation study in the Czech Republic. J Eval Clin Pract. 2014 Oct;20(5):671-7. doi: 10.1111/jep.12201. Epub 2014 Jun 11. PMID 24917035
- Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996 Mar 1;93(5):1043-65. No abstract available. PMID 8598068
Identifiers
NCT: NCT07707583 · HRV-HYP-1 · EK 29/25