Observational studyMedicine2016
Persistence to antihypertensive drug classes: A cohort study using the Swedish Primary Care Cardiovascular Database (SPCCD).
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Review of response rates over time in registry-based studies using patient-reported outcome measures.BMJ open · 2020Pooled it
- Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2020Pooled it
- The Impact of Patient Race, Patient Socioeconomic Status, and Cognitive Load of Physician Residents and Fellows on Chronic Pain Care Decisions.The journal of pain · 2024Trial
- Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.Basic & clinical pharmacology & toxicology · 2026Article
- Persistence to antihypertensive drug classes in uncomplicated hypertension: a nationwide Swedish cohort study.EClinicalMedicine · 2026Article
- LASSO logistic regression and cluster analysis in predicting adherence and drug patterns among new users of monotherapy for antihypertensive drugs.Journal of hypertension · 2025Article
- Estimated impact of guidelines-based initiation of dual antihypertensive therapy on long-term cardiovascular outcomes in 1.1 million individuals.European heart journal. Cardiovascular pharmacotherapy · 2025Article
- Factors associated with medication adherence among young adults with hypertension.Clinical hypertension · 2025Article
- Lifestyle counseling in patients with hypertension in primary health care and its association with antihypertensive pharmacotherapy.Journal of clinical hypertension (Greenwich, Conn.) · 2024Article
- Medical Measures in Hypertensives Considered Resistant.American journal of hypertension · 2024Article
- Relationship between antihypertensive drug use and number of people with high blood pressure in FY 2018: a descriptive epidemiological study based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data.Journal of pharmaceutical health care and sciences · 2023Article
- Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health.Metabolites · 2023Review
- Article
- Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Effect of patient and treatment factors on persistence with antihypertensive treatment: A population-based study.PloS one · 2021Observational
- Beta blocker rebound phenomenon is important, but we do not know its definition, incidence or optimal prevention strategies.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Review
- Methods for constructing treatment episodes and impact on exposure-outcome associations.European journal of clinical pharmacology · 2020Observational
- Fixed Versus Free Combinations Of Antihypertensive Drugs: Analyses Of Real-World Data Of Persistence With Therapy In Italy.Patient preference and adherence · 2019Article
- Sex differences in spontaneous reports on adverse drug events for common antihypertensive drugs.European journal of clinical pharmacology · 2018Article
- Drug treatment of hypertension in Sweden in relation to sex, age, and comorbidity.Journal of clinical hypertension (Greenwich, Conn.) · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim was to study persistence to, and switching between, antihypertensive drug classes and to determine factors associated with poor persistence.This was an observational cohort study. The Swedish Primary Care Cardiovascular Database includes data from medical records, socioeconomic data, filled prescriptions, and hospitalizations from national registries for 75,000 patients with hypertension. Patients included in the study were initiated on antihypertensive drug treatment in primary healthcare in 2006 to 2007. We defined class persistence as the proportion remaining on the initial drug class, including 30 days of gap. Patients with a filled prescription of another antihypertensive drug class after discontinuation of the initial drug, including 30 days of gap, were classified as switchers. Persistence to the various drug classes were compared with that for diuretics.We identified 4997 patients (mean age 60 ± 12 years in men and 63 ± 13 years in women). Out of these, 95 (2%) filled their first prescription for fixed combination therapy and 4902 (98%) for monotherapy, including angiotensin converting enzyme inhibitors (37%), angiotensin receptor blockers (4%), beta blockers (21%), calcium channel blockers (8%), and diuretics (28%). Persistence to the initial drug class was 57% after 1 year and 43% after 2 years. There were no differences in persistence between diuretics and any of the other antihypertensive drug classes, after adjustment for confounders. Discontinuation (all adjusted) was more common in men (P = 0.004), younger patients (P < 0.001), those with mild systolic blood pressure elevation (P < 0.001), and patients born outside the Nordic countries (P < 0.001). Among 1295 patients who switched drug class after their first prescription, only 21% had a blood pressure recorded before the switch occurred; and out them 69% still had high blood pressures.In conclusion, there appears to be no difference in drug class persistence between diuretics and other major antihypertensive drug classes, when factors known to be associated with poor persistence are taken into account.
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