Effect of persistent use of antihypertensives on blood pressure goal attainment.
OBJECTIVE
Discontinuation rates with antihypertensive drugs in real life are high. The present study investigates the relationship between persistence with antihypertensive drugs (AHT) and blood pressure (BP) goal attainment in daily clinical practice.


METHODS
In the PHARMO Record Linkage System, which includes drug dispensing and hospital records for > 2 million inhabitants in the Netherlands, new users of AHT > or = 18 years were identified for the period 1999-2004. Patients with elevated blood pressure (systolic BP > or = 140 and/or diastolic BP > or = 90 mmHg) within 6 months prior to onset of AHT treatment and a BP measurement within 6-12 months of treatment onset were included in the study cohort. Persistent AHT use was determined by summing the number of days of continuous treatment (gap between dispensings < 30 days) from start of treatment onwards. Patients with a BP below 140/90 mmHg at the first BP measurement within 6-12 months of treatment onset were defined as having attained goal.


RESULTS
The study included 1271 patients with a mean systolic BP of 174 +/- 22 mmHg and a mean diastolic BP of 100 +/- 12 mmHg. Persistent AHT use was associated with a 40% increased chance of BP goal attainment (RR(adj) = 1.41; 95% CI: 1.08-1.85) after adjustment for gender, age, systolic blood pressure at start, and time to the BP measurement.


CONCLUSIONS
Persistent use of AHT leads to increased blood pressure goal attainment in daily clinical practice.
Breekveldt-Postma
Nancy S
NS
PHARMO Institute, Utrecht, The Netherlands.
Penning-van Beest
Fernie J A
FJ
Siiskonen
Satu J
SJ
Koerselman
Jeroen
J
Klungel
Olaf H
OH
Falvey
Heather
H
Vincze
Gábor
G
Herings
Ron M C
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D019992:Databases as Topic; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents