Strengths
nonadherence, white-coat hypertension
One of the most important strengths of the RHYME-RCT trial is that patients were selected based on blood pressure rather than a suspicion of being nonadherent. Because of this, selection bias was minimized and all patients with and without suspicion of nonadherence were included.Second, to minimize white-coat hypertension, all patients were obliged to do a 24-h ABPM. Approximately, one-third of the patients that went to the eligibility visit had blood pressures below the threshold for participation in the trial, which shows the value of reliable blood pressure measurements. It should be noted that improved adherence also played a role in this large exclusion of patients at t0, as stated previously.Furthermore, nonadherence was established with an objective and accurate method namely measuring drug concentrations in blood sampled with DBS. False-positive and negative results were minimized by previous validation studies and thereby it was known that all included drugs could be measured up and till 24 h after intake [Participation in the RHYME-RCT trial resulted in a better intake of AHDs and an improvement in blood pressure with an average decrease of 12 mmHg SBP and 5.5 mmHg DBP in the whole study population. These improvements are clinically relevant and cannot be matched by adding more AHDs to a patient's therapy [