Back to Journals » ClinicoEconomics and Outcomes Research » Volume 3

Adherence to antihypertensive medications and health outcomes among newly treated hypertensive patients

Authors Degli Esposti L, Saragoni S, Benemei S, Batacchi P, Geppetti P, Di Bari M, Marchionni N, Sturani A, Buda S, Degli Esposti E

Published 7 March 2011 Volume 2011:3 Pages 47—54


Review by Single-blind

Peer reviewer comments 3

Luca Degli Esposti1, Stefania Saragoni1, Silvia Benemei3, Paolo Batacchi2, Pierangelo Geppetti3, Mauro Di Bari3, Niccolò Marchionni3, Alessandra Sturani4, Stefano Buda1, Ezio Degli Esposti4
1CliCon S.r.l. Health, Economics and Outcomes Research, Ravenna, Italy; 2Pharmaceutical Policy Department, Local Health Unit of Florence, Florence, Italy; 3CIRFF, University of Florence, Florence, Italy; 4Outcome Research Unit. Policlinics Umberto I, Rome, Italy

Objective: To evaluate adherence to antihypertensive therapy (AHT) and the association between adherence to AHT, all-cause mortality, and cardiovascular (CV) morbidity in a large cohort of patients newly treated with antihypertensives in a clinical practice setting.
Methods: An administrative database kept by the Local Health Unit of Florence (Italy) listing patient baseline characteristics, drug prescription, and hospital admission information was used to perform a population-based retrospective study including patients newly treated with antihypertensives, ≥18 years of age, with a first prescription between January 1, 2004 and December 31, 2006. Patients using antihypertensives for secondary prevention of CV disease, occasional spot users, and patients with early CV events, were excluded from the study cohort. Adherence to AHT was calculated and classified as poor, moderate, good, and excellent. A Cox regression model was conducted to determine the association among adherence to AHT and risk of all-cause mortality, stroke, or acute myocardial infarction.
Results: A total of 31,306 patients, 15,031 men (48.0%), and 16,275 women (52.0%), with a mean age of 60.2 ± 14.5 years was included in the study. Adherence to AHT was poor in 8038 patients (25.7% of included patients), moderate in 4640 (14.8%), good in 5651 (18.1%), and excellent in 12,977 (41.5%). Compared with patients with poor adherence (hazard ratio [HR] = 1), the risk of all-cause death, stroke, or acute myocardial infarction was significantly lower in patients with good (HR = 0.69, P < 0.001) and excellent adherence (HR = 0.53, P< 0.001).
Conclusions: These findings indicate that suboptimal adherence to AHT occurs in a substantial proportion of patients and is associated with poor health outcomes already in primary prevention of CV diseases. For health authorities, this preliminary evidence underlines the need for monitoring and improving medication adherence in clinical practice.

Keywords: antihypertensive drug therapy, adherence, all-cause mortality, stroke, acute myocardial infarction

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Epidemiology, patient profile, and health care resource use for hepatitis C in Italy

Sangiorgi D, Perrone V, Buda S, Boglione L, Cariti G, Lefevre C, Nappi C, Degli Esposti L

ClinicoEconomics and Outcomes Research 2017, 9:609-616

Published Date: 10 October 2017

Antithrombotic prophylaxis of atrial fibrillation in an Italian real-world setting: a retrospective study

Ermini G, Perrone V, Veronesi C, Degli Esposti L, Di Pasquale G

Vascular Health and Risk Management 2017, 13:239-246

Published Date: 5 July 2017

Healthcare resource consumption and cost of care among patients with polycystic kidney disease in Italy

Degli Esposti L, Veronesi C, Perrone V, Buda S, Santoro A

ClinicoEconomics and Outcomes Research 2017, 9:233-239

Published Date: 27 April 2017

Residual cardiovascular risk in patients who received lipid-lowering treatment in a real-life setting: retrospective study

Perrone V, Sangiorgi D, Buda S, Degli Esposti L

ClinicoEconomics and Outcomes Research 2016, 8:649-655

Published Date: 25 October 2016

Disease progression and health care resource consumption in patients affected by hepatitis C virus in real practice setting

Perrone V, Sangiorgi D, Buda S, Degli Esposti L

ClinicoEconomics and Outcomes Research 2016, 8:591-597

Published Date: 14 October 2016

Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis

Sangiorgi D, Benucci M, Nappi C, Perrone V, Buda S, Degli Esposti L

Biologics: Targets and Therapy 2015, 9:119-127

Published Date: 6 November 2015

Adherence to statin treatment following a myocardial infarction: an Italian population-based survey

Monaldi B, Bologna G, Costa GG, D'Agostino C, Ferrante F, Filice M, Grion A, Mingarelli A, Paloscia L, Tettamanti R, Veronesi C, Degli Esposti L

ClinicoEconomics and Outcomes Research 2015, 7:273-280

Published Date: 1 June 2015

Adherence and resource use among patients treated with biologic drugs: findings from BEETLE study

Degli Esposti L, Sangiorgi D, Perrone V, Radice S, Clementi E, Perone F, Buda S

ClinicoEconomics and Outcomes Research 2014, 6:401-407

Published Date: 18 September 2014

Drug adherence to olmesartan/amlodipine fixed combination in an Italian clinical practice setting

Degli Esposti L, Saragoni S, Buda S, Degli Esposti E

ClinicoEconomics and Outcomes Research 2014, 6:209-216

Published Date: 22 April 2014

Glycemic control and diabetes-related health care costs in type 2 diabetes; retrospective analysis based on clinical and administrative databases

Degli Esposti L, Saragoni S, Buda S, Sturani A, Degli Esposti E

ClinicoEconomics and Outcomes Research 2013, 5:193-201

Published Date: 14 May 2013

Antihypertensive therapy among newly treated patients: An analysis of adherence and cost of treatment over years

Luca Degli Esposti, Stefania Saragoni, Paolo Batacchi, et al

ClinicoEconomics and Outcomes Research 2010, 2:113-120

Published Date: 28 July 2010

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

A new recombinant factor VIII: from genetics to clinical use

Santagostino E

Drug Design, Development and Therapy 2014, 8:2507-2515

Published Date: 12 December 2014

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010