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Persistence with treatment in newly treated middle-aged patients with essential hypertension

Sylvie Perreault1, Diane Lamarre, Lucie Blais

  • 1Faculty of Pharmacy, University of Montreal, Québec, Canada. sylvie.perreault@umontreal.ca

The Annals of Pharmacotherapy
|August 4, 2005
PubMed

Insights

Patient persistence with antihypertensive medication declines significantly within three years, with diuretics showing the lowest adherence rates. Early intervention is crucial for improving long-term cardiovascular disease management.

Area of Science:

  • Pharmacology
  • Cardiology
  • Public Health

Background:

  • Antihypertensive agents reduce cardiovascular disease (CVD) morbidity/mortality.
  • Hypertension remains uncontrolled in many diagnosed patients, potentially due to poor treatment persistence.
  • Understanding persistence is key to improving hypertension management.

Purpose of the Study:

  • To evaluate persistence with antihypertensive medications.
  • To identify determinants of persistence among newly treated patients.

Main Methods:

  • A cohort of 21,011 newly treated essential hypertension patients (50-64 years) was analyzed.
  • Prescription data from 1998-2000 from Quebec administrative database used.
  • Kaplan-Meier and Cox regression models assessed persistence rates and discontinuation factors over 3 years.

Main Results:

  • Persistence dropped from 75% at 6 months to 55% over 3 years.
  • Non-diuretic antihypertensives or combination therapy improved persistence (HR 0.71).
  • Diabetes (HR 0.86) and dyslipidemia (HR 0.71) were associated with increased persistence.

Conclusions:

  • Persistence barriers emerge early, with adherence declining over time.
  • Diuretic therapy demonstrated the lowest patient persistence rates.
  • Strategies to enhance early adherence are vital for effective hypertension control.
Abstract

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