Determination of five antihypertensives in dried capillary plasma spots by LC-MS/MS

Adherence to hypertension treatment is crucial for therapeutic success, as noncompliance adversely affects quality of life and healthcare costs. Assessing adherence directly through plasma drug concentrations is particularly effective for patients with complex medication regimens.

This study aimed to develop and validate an LC-MS/MS method for quantifying five antihypertensive drugs in dried capillary plasma obtained via a plasma separation device.

Hypertension progresses silently and slowly, necessitating dietary and lifestyle modifications alongside rigorous adherence to prescribed medications. The main groups of drugs include angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, calcium channel blockers, beta-blockers, and diuretics, which are known to reduce complications and mortality among patients with hypertension.

However, despite the appropriate prescription of three antihypertensive medications, including a diuretic, some patients do not achieve adequate blood pressure control, constituting cases of resistant hypertension. Therefore, due to the frequent challenges in managing hypertension, monitoring and adherence to therapy are crucial.

the analysis of antihypertensive drugs or metabolites in biological matrices has been proposed as a direct method for assessing adherence, as concentrations in plasma, serum, urine, or even hair are proportional to the amount of medication taken.

In this context, various methods have been proposed in the literature for the determination of antihypertensive drugs in biological matrices. Furthermore, due to easier sample collection and improved analyte stability, methods utilizing dried blood spot (DBS) samples have also been proposed