Hypertension is one of the most important modifiable risk factor causing cardiovascular disease. Unfortunately, non-adherence to antihypertensive medications is frequently observed in hypertensive patients and can lead to an increase in morbidity and mortality. Until recently, there was no robust clinical method to objectively diagnose non-adherence. Recently, the detection of medications in urine or blood by mass spectrometry techniques such as liquid chromatography-tandem mass spectrometry (LC-MS-MS) has been accepted as the diagnostic method of choice for the detection of non-adherence. Despite this, it is unclear whether the concentration of urine can affect the detection of medications in urine. Therefore, this study aimed to assess the effect of urine concentration on detection of antihypertensive medications by LC-MS-MS in which urine creatinine is used as an independent marker of urine concentration. Biochemical adherence results for 22 different medications (1,709 prescriptions) in 463 different subjects were converted to an adherence score. The adherence score was defined as the ratio of the total number of subjects in which the drug was detected to the total number of subjects to whom the drug was prescribed. The adherence scores for each medication were correlated with urine creatinine concentration for each medication. Non-adherence was observed in 47.1% of samples with a mean urine creatinine concentration of these samples of 9.4 ± 7.1 mmol/L. There was no significant difference between the urine creatinine concentrations in the detected vs non-detected groups for each of the 22 medications. Furthermore, there are no differences in adherence scores across the urine creatinine concentration. This is the first study to demonstrate that urine creatinine concentration does not affect the results of the adherence screening by LC-MS-MS.

中文翻译：

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尿液浓度不会影响生化测试的不粘连性。

高血压是引起心血管疾病的最重要的可改变危险因素之一。不幸的是，在高血压患者中经常观察到不坚持服用降压药，这可能导致发病率和死亡率增加。直到最近，还没有可靠的临床方法可以客观地诊断不依从性。近来，通过诸如液相色谱-串联质谱法（LC-MS-MS）的质谱技术检测尿液或血液中的药物已被接受为用于检测不粘连的选择的诊断方法。尽管如此，目前尚不清楚尿液的浓度是否会影响尿液中药物的检测。所以，本研究旨在评估尿液浓度对通过LC-MS-MS检测降压药物的影响，其中尿肌酐用作尿液浓度的独立标记。将463个不同受试者中22种不同药物（1,709张处方）的生化依从性结果转换为依从性得分。依从性分数定义为检测到药物的受试者总数与处方药物的受试者总数之比。每种药物的依从性评分与每种药物的尿肌酐浓度相关。在47.1％的样品中未观察到粘连，这些样品的尿肌酐平均浓度为9.4±7.1 mmol / L。对于22种药物，检测组和未检测组的尿肌酐浓度之间无显着差异。此外，整个尿肌酐浓度的依从性评分没有差异。这是第一项证明尿肌酐浓度不会影响LC-MS-MS依从性筛查结果的研究。