Short- and long-term discontinuation patterns of commonly prescribed antihypertensive drugs among a Chinese population: cohort study.
This retrospective cohort study compared cumulative incidences of antihypertensive drug discontinuation at 8 and 48 weeks in two public primary care clinics in Hong Kong, including 2531 patients who newly received a first-ever antihypertensive monotherapy during the period 1990-2002. from clinical patient records, thiazide diuretics had significantly lower discontinuation rates (0.00%) as compared to all other drug classes at 8 weeks in both young males ( range: 5.4-10.8% in other classes, P <0.001), while at 48 weeks calcium channel blockers (CCBs) showed the highest discontinuation rate (23.0%, 955 CI 17.0%, 29.0%) significantly different from beta-blockers (14.4%, 95% CI 10.9%, 17.9%, P=0.011) and thiazide diuretics ( 13.1 %, 95% CI 8.6%, 17.6%, P=0.010) in young females ( overall P= 0.041). This finding highlights cautions of higher rates of discontinuing CCBs in the long term, and the lower short-term discontinuation rates of thiazides than other drug classes, which strengthens the recommendations from international authorities such as the British Hypertension Society as a best first-line drug for Chinese patients.
Wong
M C S
MC
Department of Community and Family Medicine, School of Public Health, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China. wong_martin@cuhk.edu.hk
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002120:Calcium Channel Agonists / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D049971:Thiazides / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002120:Calcium Channel Agonists; D049971:Thiazides