Adherence to anti-hypertensive medication based on class

January 01, 0001

Adherence to anti-hypertensive medication based on class

There has been some suggestion that there is differing adherence with antihypertensive medications of different classes. These US researchers Examined the association between adherence and antihypertensive drug class via a systematic search of English-language articles. Seventeen studies met inclusion criteria.An inverse-variance-weighted random-effects model was utilized.

The researchers found: "The pooled mean adherence by drug class ranged from 28% for beta-blockers to 65% for angiotensin II receptor blockers. There was better adherence to angiotensin II receptor blockers compared with angiotensin-converting enzyme inhibitors (HR, 1.33), calcium channel blockers (HR, 1.57), diuretics (HR, 1.95), and beta-blockers (HR, 2.09). Conversely, there was lower adherence to diuretics compared with the other drug classes. The same pattern was present when studies that used odds ratios were pooled. After publication bias was accounted for, there were no longer significant differences in adherence between angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors or between diuretics and beta-blockers."

The researchers concluded: "In clinical settings, there are important differences in adherence to antihypertensives in separate classes, with lowest adherence to diuretics and beta-blockers and highest adherence to angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors. However, adherence was suboptimal regardless of drug class."

This meta-analysis finds important differences in adherence based on class of anti-hypertensive medication.

For the full abstract, click here.

Circulation 123(15):1611-1621, 19 April 2011 © 2011 American Heart Association, Inc.
Meta-Analysis: Impact of Drug Class on Adherence to Antihypertensives. Ian M. Kronish, Mark Woodward, Ziad Sergie, Gbenga Ogedegbe, Louise Falzon, Devin M. Mann. Correspondence to Ian Kronish: [email protected]

Category: K. Circulatory. Keywords: hypertension, adherence, anti-hypertensives, beta-blockers, diuretics, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 17 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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