Choice of initial antihypertensive medication and continuation of use

Three recent studies that have focused on the discontinuation of initial antihypertensive medications are reviewed. The studies reviewed indicate that newly prescribed antihypertensive medications are associated with high levels of discontinuation in the months following the initiation of treatment. After six months, less than 50% of patients are on initial treatment regardless of which of the following classes of medication has been prescribed: diuretics, beta-blockers, calcium antagonists or angiotensin-converting enzyme inhibitors. A higher proportion of patients on losartan than on angiotensin-converting enzyme inhibitors continue their initial treatment after 12 months. More research designed to assess the effectiveness of treatments in real life situations is needed. In particular, there is a need to clarify the role of side effects on continuation of initial treatment.