Effect of persistent use of anti hypertensives 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 anti hypertensive 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 >= 18 years were identified for the period 1999-2004. Patients with elevated blood pressure (systolic BP >= 40 and/or diastolic BP >= 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 bysumming 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 (RRadj = 1.41; 95% Cl: 1.08-1.85) after adjustment for gender, age, systolic blood pressure at start, and time to the BP measurement. Conclusion: Persistent use of AHT leads to increased blood pressure goal attainment in daily clinical practice