SynthesisCirculation2011
Meta-analysis: impact of drug class on adherence to antihypertensives.
Synthesis in Circulation, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- Interventions for reducing blood pressure in prehypertension: A meta-analysis.Frontiers in public health · 2023Pooled it
- Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis.Maturitas · 2021Pooled it
- Cumulative childhood adversity and adult cardiometabolic disease: A meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2018Pooled it
- Improving adherence with medication: a selective literature review based on the example of hypertension treatment.Deutsches Arzteblatt international · 2014Pooled it
- Low-Dose TEL/AML/CHTD SPC Versus Standard-Dose TEL in Hypertension: Phase III RCT.Hypertension (Dallas, Tex. : 1979) · 2026Trial
- Association of Angiotensin II-Stimulating Antihypertensive Use and Dementia Risk: Post Hoc Analysis of the PreDIVA Trial.Neurology · 2021Trial
- Trial
- Are two commonly used self-report questionnaires useful for identifying antihypertensive medication nonadherence?Journal of hypertension · 2015Trial
- Overcoming Psychological Barriers to Treatment Adherence: The Case of Antihypertensive Medication.Cardiology clinics · 2026Review
- Adherence to PCSK9 Inhibitors in Clinical Practice: Systematic Review and Meta-Analysis of Observational Studies.JACC. Advances · 2026Article
- Estimating hypertension medication adherence among adults using linked Belgian health interview survey and administrative pharmacy refill data.BMC public health · 2026Article
- Trends and Predictors of Antihypertensive Medication Adherence in Commercially Insured Adults under 65 (2018-2023).Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Development and Validation of Predictive Models for Non-Adherence to Antihypertensive Medication.Medicina (Kaunas, Lithuania) · 2025Article
- Factors associated with medication adherence among young adults with hypertension.Clinical hypertension · 2025Article
- Comparative effectiveness and prescribing trends of modified release versus immediate release indapamide in patients with hypertension: cohort study.BMJ medicine · 2025Article
- Outpatient management of essential hypertension: a review based on the latest clinical guidelines.Annals of medicine · 2024Review
- Strategies for improving the treatment and control of hypertension in Japan.Journal of human hypertension · 2024Review
- Review
- A Retrospective Observational Real-Word Analysis of the Adherence, Healthcare Resource Consumption and Costs in Patients Treated with Bisoprolol/Perindopril as Single-Pill or Free Combination.Advances in therapy · 2024Observational
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundObservational studies suggest that there are differences in adherence to antihypertensive medications in different classes. Our objective was to quantify the association between antihypertensive drug class and adherence in clinical settings. METHODS AND
resultsStudies were identified through a systematic search of English-language articles published from the inception of computerized databases until February 1, 2009. Studies were included if they measured adherence to antihypertensives using medication refill data and contained sufficient data to calculate a measure of relative risk of adherence and its variance. An inverse-variance-weighted random-effects model was used to pool results. Hazard ratios (HRs) and odds ratios were pooled separately, and HRs were selected as the primary outcome. Seventeen studies met inclusion criteria. The pooled mean adherence by drug class ranged from 28% for β-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; 95% confidence interval, 1.13 to 1.57), calcium channel blockers (HR, 1.57; 95% confidence interval, 1.38 to 1.79), diuretics (HR, 1.95; 95% confidence interval, 1.73 to 2.20), and β-blockers (HR, 2.09; 95% confidence interval, 1.14 to 3.85). 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 β-blockers.
conclusionIn clinical settings, there are important differences in adherence to antihypertensives in separate classes, with lowest adherence to diuretics and β-blockers and highest adherence to angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors. However, adherence was suboptimal regardless of drug class.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.