Key result
Complex multiple-pill antihypertensive regimens are linked to ~50% lower odds of BP goal achievement.
Why the study?
Blood pressure control among people with hypertension remains inadequate, prompting this study to assess blood pressure goal achievement, medication nonadherence, and associated demographic factors among adults prescribed antihypertensives.
What are the rates of blood pressure goal achievement and medication nonadherence, and what patient and regimen factors are associated with them, among middle-to-older-aged adults prescribed antihypertensive medications in primary care?
Cross-Sectional (n=567)
No
What are the rates of blood pressure goal achievement and medication nonadherence, and what patient and regimen factors are associated with them, among middle-to-older-aged adults prescribed antihypertensive medications in primary care?
Answers are grounded in this paper and cite their sources.
In an Irish primary care cohort of treated hypertensive adults, over one-third failed to achieve 2013 guideline BP targets (increasing to over 60% under stricter 2024 ESC targets), with complex multi-pill regimens, higher BMI, and medication nonadherence significantly hindering optimal BP control.
Background Blood pressure (BP) control among hypertensive people remains inadequate. This study aims to assess BP goal achievement among people prescribed antihypertensives, to examine medication nonadherence, and to identify demographics associated with goal achievements and medication nonadherence in this population. Methods This was a cross‐sectional analysis of the Mitchelstown Cohort Study Rescreen data. Goal achievement was assessed in accordance with the 2013 European guidelines, the guidelines in place during data collection. A validated, self‐reported 3‐item medication nonadherence questionnaire was used, with a mean score ranging from 1 (Perfect Adherence) to 5 (Perfect Nonadherence). Nonadherence was defined as mean score > 1. Multiple imputation was used to impute missing data on covariates and outcomes. A sensitivity analysis was performed to assess the consistency of results by applying the 2024 European guideline recommendations. Multivariable logistic regression analysis was used to identify the factors associated with BP goal achievements and medication nonadherence. Results Antihypertensives were prescribed to 567 participants. Based on imputed data, 63.8% of these achieved 2013 BP goal. Mean medication nonadherence score was 1.6 (SE ± 0.06), with 34.8% participants being nonadherent. Having multiple antihypertensives pills was associated with lower likelihood of achieving BP goals. In the sensitivity analysis, 38.4% achieved 2024 BP goal and in multivariable analysis, being overweight or obese was associated with not achieving the 2024 goals. Conclusion The study highlights the gap between guideline BP goals and achieving these goals in real world practice. Key patient and medication factors were identified that could guide efforts to improve BP goal achievement. Trial Registration: ClinicalTrials.gov identifier: NCT03191227
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Elhiny et al. (2026) conducted a cross-sectional in Hypertension (prescribed antihypertensive medications) (n=567). Complex antihypertensive regimen (free-equivalent combination plus single pill combination) vs. Antihypertensive monotherapy was evaluated on Achievement of 2013 ESC/ESH blood pressure goals (SBP < 140 mmHg and DBP < 90 mmHg, or < 85 mmHg for patients with diabetes) (OR 0.50, 95% CI 0.25-0.97, p=0.043). Among 567 adults prescribed antihypertensives, 63.8% achieved 2013 BP goals and 34.8% were nonadherent, with complex multiple-pill regimens reducing goal achievement (OR 0.50, p=0.043).
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