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Adherence to oral antihypertensive medications, are all medications equal?

Michal Shani1,2, Alex Lustman1,2, Shlomo Vinker2

  • 1Department of Family Medicine Central District, Clalit Health Service, Rehovot, Israel.

Journal of Clinical Hypertension (Greenwich, Conn.)
|February 9, 2019
PubMed

Insights

Medication adherence rates for oral antihypertensives varied significantly, from 53% to 71%. Good adherence to any medication improved health outcomes and was linked to better adherence to other prescribed drugs.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Public Health

Background:

  • Medication adherence is crucial for managing chronic diseases like hypertension.
  • Poor adherence leads to adverse health outcomes and increased healthcare costs.

Purpose of the Study:

  • To investigate adherence rates for various oral antihypertensive medications.
  • To examine the relationship between medication adherence and clinical outcomes (systolic blood pressure and LDL levels).
  • To explore cross-adherence patterns among different drug classes.

Main Methods:

  • Retrospective cohort study of 31,530 patients aged 40-75 with hypertension in Israel.
  • Analysis of prescription data for specific antihypertensives and statins between 2012-2014.
  • Definition of 'good adherence' as purchasing at least nine monthly prescriptions in 2013.

Main Results:

  • Good adherence rates ranged from 53% (statins, hydrochlorothiazide) to 71% (amlodipine).
  • Patients with good adherence showed significantly lower systolic blood pressure and LDL levels.
  • Higher adherence was associated with advanced age and polypharmacy; poor adherence to one drug correlated with lower adherence to others.

Conclusions:

  • Adherence rates differ across antihypertensive medications.
  • Interventions to improve medication adherence may yield substantial benefits for chronic disease management.
  • Adherence to one medication positively influences adherence to others, highlighting the importance of a holistic approach.

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