Strict Adherence to Antihypertensive Drugs Lowers ESRD Risk

Better adherence to antihypertensive (AH) drug therapy is associated with a reduced risk of end-stage renal disease (ESRD), according to a Canadian study.

Researchers led by Sylvie Perreault, BPharm, PhD, of the University of Montreal, studied 185,476 patients aged 45-85 who were newly diagnosed with hypertension. Adherence level was determined by medication possession ratio, which corresponds to the total number of days' supply of medication dispensed divided by the length of follow-up. The median follow-up was 5.1 years.

An adherence level of 80% or greater to AH agents compared with a lower level was associated with a 33% decreased risk of ESRD in adjusted analyses, the researchers reported online ahead of print in Kidney International.

The researchers acknowledged that one of the study limitations was the use of prescription refill patterns to assess exposure. Thus, they could not ascertain whether dispensed medications were actually taken by patients. Some available evidence, however, suggests a good correlation between pharmacy dispensing records and cumulative drug exposure and gaps in medication supply, they wrote.

“The assessment of medication adherence should be incorporated into routine clinical practice,” the authors concluded. “Strategies for optimizing long-term adherence to AH agents must be promoted to reduce or at least delay the occurrence of ESRD of newly hypertensive patients.”

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