Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.
A, A., S, M., JHJ, B., CCM, S.V., E, H., & K, T. (2026). Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.. Basic & clinical pharmacology & toxicology. https://doi.org/10.1111/bcpt.70286
A A, S M, JHJ B, CCM SV, E H, K T. Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.. Basic & clinical pharmacology & toxicology. 2026; doi: 10.1111/bcpt.70286
A A, S M, JHJ B, et al. Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.[J]. Basic & clinical pharmacology & toxicology. 2026. DOI: 10.1111/bcpt.70286.
@article{a2026,
author = {Asiri A and Mubarik S and Bos JHJ and Schuiling-Veninga CCM and Hak E and Taxis K},
title = {Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study.},
journal = {Basic & clinical pharmacology & toxicology},
year = {2026},
doi = {10.1111/bcpt.70286},
note = {PMID: 42595960},
}
TY - JOUR AU - Asiri A AU - Mubarik S AU - Bos JHJ AU - Schuiling-Veninga CCM AU - Hak E AU - Taxis K TI - Long-Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5-Year Cohort Study. T2 - Basic & clinical pharmacology & toxicology PY - 2026 DO - 10.1111/bcpt.70286 AN - PMID:42595960 ER -
AIM: To estimate persistence with antihypertensive therapy (AHT) and describe treatment changes and associated factors among persistent patients over 5 years. METHODS: We conducted a longitudinal cohort study using the IADB.nl pharmacy database in the Netherlands, including adults who initiated AHT between 2014 and 2018 after a 2-year washout. Persistence was assessed annually using a ±45-day window around each treatment anniversary. Among patients persistent throughout follow-up, treatment changes were classified yearly as no change, switching, intensification or de-intensification. A Markov model estimated transitions between treatment states, and logistic regression evaluated baseline factors associated with treatment changes. RESULTS: Among 22 027 starters (mean age 58.1 years, 51.1% women), annual persistence declined from 88.8% in year 1 to 80.7% in year 5, with 52.7% remaining persistent over 5 years. Treatment changes were most frequent in the first year, when 53.5% of persistent patients underwent intensification, de-intensification, or switching, and declined thereafter. The probability of remaining in the same state was high, particularly for 'no change' state (0.86). Female sex, combination therapy initiation and initiating on beta-blockers or calcium-channel blockers were associated with treatment changes. CONCLUSION: Antihypertensive pharmacotherapy is frequently modified early after initiation, followed by increasing long-term treatment stability among persistent users.