Related Experiment Videos

A population-based European cohort study of persistence in newly diagnosed hypertensive patients

J Hasford1, A Mimran, W R Simons

  • 1Department for Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany. has@ibe.med.uni-muenchen.de

Journal of Human Hypertension
|August 1, 2002
PubMed

Insights

Patients taking irbesartan, an angiotensin II receptor antagonist (AIIRA), showed the highest persistence with antihypertensive therapy after one year. This suggests medication choice impacts long-term blood pressure control.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Antihypertensive therapy adherence is crucial for effective blood pressure management.
  • Understanding factors influencing patient persistence with initial treatment is essential for optimizing hypertension care.
  • Previous studies have highlighted variability in adherence across different drug classes.

Purpose of the Study:

  • To assess 1-year persistence rates among patients initially prescribed monotherapy for hypertension.
  • To compare persistence rates for irbesartan (an angiotensin II receptor antagonist - AIIRA) against other AIIRAs and different antihypertensive drug classes.
  • To identify which initial antihypertensive monotherapy is associated with the highest patient persistence.

Main Methods:

  • Retrospective analysis of medical records for 2416 patients with newly diagnosed hypertension across Germany, France, and the UK.
  • Patients were prescribed initial antihypertensive monotherapy by general practitioners.
  • Persistence rates were compared among irbesartan, other AIIRAs, angiotensin-converting enzyme inhibitors, calcium channel blockers, beta-blockers, losartan, and diuretics.

Main Results:

  • Irbesartan demonstrated the highest persistence rate at 60.8% after 1 year.
  • Other AIIRA agents showed a persistence rate of 51.3%.
  • Angiotensin-converting enzyme inhibitors, calcium channel blockers, beta-blockers, and losartan had comparable persistence rates (42.0%-49.7%), while diuretics had the lowest (34.4%).

Conclusions:

  • Initial prescription of irbesartan is associated with significantly higher patient persistence compared to other antihypertensive classes.
  • Patient persistence with antihypertensive therapy is a key factor for achieving sustained blood pressure control.
  • Optimizing antihypertensive prescribing based on efficacy and tolerability may improve long-term adherence and outcomes.

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.