Take Blood Pressure Pills on Schedule

High blood pressure medications when not taken correctly increase risk of stroke

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Along with regular exercise and eating a healthy diet, medications can lower high blood pressure. Treatment, however, has to be taken as directed by your doctor.

While high blood pressure (hypertension) can lead to heart attack, stroke and kidney disease, the condition is manageable. Healthcare professionals often prescribe medications for high blood pressure. The American Heart Association says that for these pills to be effective, it may require taking them every day for the rest of a person’s life.

A large new study has found that those who did not take their antihypertensive medication as prescribed had a greatly increased risk of having a stroke compared to those who took it correctly.

"Take high blood pressure medication as directed."

Dr. Kimmo Herttua, a senior fellow in the Population Research Unit at the University of Helsinki, Finland, along with fellow scientists, analyzed data on 73,527 people with high blood pressure. These patients were all Finnish and age 30 and up.

The researchers based their findings on how often patients filled their prescriptions during the 12-year period between 1995 and 2007. The investigators noted, however, that they could not be sure that patients were actually taking their medications, even though they had collected their prescriptions, and the registries did not give them information on body mass index, smoking, alcohol consumption and resting blood pressure.

Patients who were not getting their prescriptions as directed were more likely to die of stroke compared to those who followed the prescription schedule, according to the authors. In the second year after first being prescribed blood pressure medication, the non-adherent patients (those not taking their medications as directed) had almost a four times greater risk of dying from stroke compared to the adherent ones.

Over time, the risk of dying from stroke dropped among those who do not stick with their medication schedule, but they still faced a greater likelihood than those who adhered to the treatment.

Dr. Herttua and his team found that in the tenth year after first being issued medication, the non-adherents were three times as likely to die from stroke compared to those who kept up with their medication schedule.

In the year that non-adherent patients died from stroke, they had a 5.7 times greater risk than the ones who stuck to the regimen.

Patients who didn't take their medication as directed were also more likely to be admitted to hospital after a stroke. During the 12-year timeframe of the study, 24,560 patients were hospitalized with a stroke, and 2,144 died from stroke.

Non-adherent individuals faced a 2.7-fold higher risk for hospitalization in the second year after first receiving antihypertensive prescriptions compared to adherent patients. In the tenth year, that risk was 1.7-fold higher.

The authors considered patients as adhering to their medications if they took them correctly more than 80 percent of the time. The non-adherent patients were divided into two groups: those with intermediate adherence (correctly following treatment 30 to 80 percent of the time) and those with poor adherence (with less than 30 percent adherence).

"These results emphasize the importance of hypertensive patients taking their antihypertensive medications correctly in order to minimize their risk of serious complications such as fatal and non-fatal strokes,” said Dr. Herttua in a press release. “Non-adherent patients have a greater risk even ten years before they suffer a stroke.”

The authors also examined specific classes of antihypertensive medications. They found that among patients who were taking medications that acted on the renin-angiotensin system combined with diuretics or beta-blockers, those who were non-adherent had a 7.5 times greater risk of death and a nearly four-fold increased risk of hospitalization in the year that these events occurred, compared to patients who took their medications correctly.

This study was published online in July in the European Heart Journal.

The research was supported by the Academy of Finland, the UK Medical Research Council, the UK Economic and Social Research Council and the US National Institutes of Health.

Reviewed by: 
Review Date: 
July 23, 2013
Last Updated:
July 26, 2013