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Persistence and adherence to antihypertensive treatment in relation to initial prescription: diuretics versus other classes of antihypertensive drugs
Journal of Hypertension, 05/14/2012
Clinical Article
Trimarco V et al. – These results demonstrate that the recommendation to start antihypertensive therapy with diuretics, when no compelling indications are present, is not supported by the evidence that this strategy produces more rapid and better control of blood pressure (BP).
Methods- Ninety–two general practitioners (GPs) recruited 2409 hypertensive patients with indication to antihypertensive therapy, who were randomized in two arms to start treatment with chlortalidone (12.5–25mg daily) or any other single medications (excluding thiazides).
- The patients have been followed for at least 2 years.
- Patients receiving diuretic therapy as first–line antihypertensive treatment, modified antihypertensive treatment regimen more often than the others (79.1 versus 43.9%; X2<0.0001).
- Patients starting with diuretics received greater number of drugs, compared to patients starting with different antihypertensive therapy (1.55 versus 1.4 antihypertensive drugs; P<0.0001), but achieved the same blood pressure (BP) control during the follow–up.
- No differences were observed in persistence and adherence to treatment between the two groups.