What question did this study set out to answer?

To assess 12-month persistence with antihypertensive drug therapy and determine how patients' cardiovascular risk profiles influence continuation rates.

November 19, 2013International Journal of Clinical PracticeOpen Access

The impact of cardiovascular profile on persistence associated with antihypertensive medications

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Why the study?

Does the choice of antihypertensive medication (AIIAs or ACE inhibitors vs thiazide diuretics) improve treatment persistence in patients newly prescribed for hypertension?

Population

6,924 patients first prescribed for hypertension in 2008 from the principal French National Public Health…

Comparison

Angiotensin II antagonists or… vs Thiazide diuretics

Design

Cohort

Follow-up

12 months

Authors

FMF. MidySanté Publique France ARA. RudnichiAgence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail

Discussion

Member takes

Implication

May favor ACE inhibitors or AIIAs over thiazides for persistence; extends observational data but leaves open randomized confirmation.

Key Points

To assess 12-month persistence with antihypertensive drug therapy and determine how patients' cardiovascular risk profiles influence continuation rates.
Retrospectively analyzed N=6,924 patients with an initial hypertension prescription in 2008 using the French National Public Health Insurance Scheme database.
Tracked therapy over 12 months post-index date, defining persistence as remaining on treatment at the end of the year.
Used Cox proportional hazards regression models adjusted for patient demographics and cardiovascular risk profiles to compare medication classes.
Overall, 65% of patients remained persistent on antihypertensive therapy at 1 year, but only 16% maintained their initial medication regimen.
After adjustment, patients taking angiotensin II antagonists and ACE inhibitors had a 13% and 11% lower risk of discontinuation, respectively, compared with thiazide diuretics.
In primary prevention patients without diabetes or hyperlipidemia, angiotensin II antagonists and ACE inhibitors reduced discontinuation risk by 19% compared to thiazides, while no class differences occurred in secondary prevention.

Structured PICO

Does the choice of antihypertensive medication (AIIAs or ACE inhibitors vs thiazide diuretics) improve treatment persistence in patients newly prescribed for hypertension?

Population

6,924 patients first prescribed for hypertension in 2008 from the principal French National Public Health Insurance Scheme database

Intervention

Angiotensin II antagonists (AIIAs) or angiotensin-converting enzyme inhibitors (ACE)

Comparator

Thiazide diuretics

Outcome

Persistence (remaining on therapy at the end of the 12 months postindex date)

Persistence with antihypertensive therapy is influenced by the patient's cardiovascular profile and drug class, with ACE inhibitors and ARBs showing better persistence than thiazide diuretics in primary prevention.

Cite This Study

Midy et al. (2013) studied this question.

synapsesocial.com/papers/6a70f35431a3df8243293294 https://doi.org/10.1111/ijcp.12253

Topics

Hypertension management Women and heart disease Cardiovascular prevention

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The impact of cardiovascular profile on persistence associated with antihypertensive medications

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The impact of cardiovascular profile on persistence associated with antihypertensive medications

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider