Hypertension continuation adherence: natural history and role as an indicator condition

Abstract

A random sample of general medicine clinic patients were analyzed to determine the natural history of newly treated hypertensive (NH) patients: discontinuation patterns; critical intervention periods; and hypertensive (HBP) utility as an indicator condition. The NH patients exhibited a 48% dropout rate in the 1st year and better continuation adherence than new nonhypertensive (NNH) patients. Patients with HBP and other chronic diseases had better continuation adherence than those with HBP alone but no predictive patterns emerged. New patients displayed rapid early discontinuation with further linear decline by 4 mo. for NNH and by 8 mo. for NH patients. All patients showed similar subsequent falloff: linear annual decline at 13-36%. Apparently discontinuation rates are unacceptably high, intervention must be continued throughout treatment and HBP has limited utility as an indicator chronic disease.