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Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based

C Bourgault1, M Sénécal, M Brisson

  • 1Health Economics and Outcomes Research, Merck Frosst Canada Ltd., 16-711 TransCanada Highway, Kirkland, Quebec, Canada H9H 3L1. chantal.bourgault@merck.com

Journal of Human Hypertension
|May 28, 2005
PubMed

Insights

Patients starting angiotensin II antagonists (AIIAs) for hypertension showed better persistence and were more likely to restart treatment after discontinuation compared to other antihypertensive drug classes.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Health Services Research

Background:

  • Antihypertensive therapy (AHT) adherence is crucial for managing hypertension.
  • Understanding discontinuation patterns across different AHT classes is vital for optimizing patient care.

Purpose of the Study:

  • To evaluate persistence with and discontinuation of various antihypertensive drug classes.
  • To compare reinitiation patterns following treatment cessation in a Canadian population.

Main Methods:

  • Retrospective cohort study of 21,326 hypertensive patients initiating AHT monotherapy.
  • Analysis of Saskatchewan health-care databases over 3 years.
  • Kaplan-Meier and Cox regression analyses to compare persistence and reinitiation.

Main Results:

  • Angiotensin II antagonists (AIIAs) demonstrated significantly higher persistence compared to ACE inhibitors, CCBs, beta-blockers, and diuretics.
  • Patients initiating AIIAs were more likely to restart AHT after discontinuation.
  • 54-75% of patients initiated a second course of AHT within a year of discontinuation.

Conclusions:

  • Initiating antihypertensive therapy with AIIAs is associated with improved persistence and higher likelihood of reinitiation post-discontinuation.
  • Treatment behaviors and their impact on health outcomes and costs warrant further investigation.

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