Nonadherence to blood pressure lowering medication is common clinically (one in four) and a simple urine test can help clinicians identify these patients and potentially avoid further costly work-ups, according to a study published online April 2 in Heart. This urine test could potentially fill a gap by providing an objective and direct-detection clinical tool to identify hypertension therapy noncompliance and could aid in better stratifying patients needing further costly intervention. In the present study, 208 hypertensive patients (125 new referrals, 66 follow-up patients with inadequate blood pressure control previously seen in the specialty clinic, and 17 renal denervation referrals) were evaluated for anti-hypertensive drug compliance using high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. The researchers found that one-quarter of patients were totally or partially nonadherent to anti-hypertensive treatment (total nonadherence equaled 10.1 percent; partial nonadherence equaled 14.9 percent). Follow-up patients with inadequate blood pressure control (28.8 percent) and those referred for consideration of renal denervation (23.5 percent) had the highest prevalence of nonadherence. “A majority of these [nonadherent] patients in any secondary/tertiary care center would routinely undergo many additional tests and procedures in search of the explanation for their apparent unresponsiveness to standard therapy prescribed by primary […]