High blood pressure is a major risk factor for cardiovascular disease and premature death. Although many effective medications lower blood pressure and extend lifespan, some patients fail to achieve their treatment goals, and many discontinue their medication. Therefore, a recent study based on data from over 340,000 patients in Sweden aimed to determine the impact of first-line medication choice on long-term adherence to treatment.
The study compared four classes of medications commonly recommended for treating hypertension: angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and thiazide or thiazide-like diuretics (TDs). The study included patients with no prior history of cardiovascular disease who began treatment between 2011 and 2018, with follow-up for several years.
The results showed that 80% of patients who started using an ARB continued taking the same class of medication after five years, compared to 65% of those using calcium channel blockers, the second-best category. Those who discontinued their original medication mostly continued treatment with another blood pressure-lowering drug, often from the ARB class.
Carl Laurel, a researcher at Uppsala University, says: "Encouraging patients to adhere to their blood pressure treatment promotes cardiovascular health and prolongs their lives. Prescribing medications that patients are more likely to continue taking from the outset also reduces healthcare costs."
Laurel adds: "ARBs cause fewer side effects than others. Patients who find a drug effective and without side effects have no reason to change it. However, it is essential to monitor blood pressure regularly, as it often rises with age, and additional medications may be required if needed."
The study was published in the journal eClinicalMedicine.
