Medication Persistence in Hypertension in General Practice

  • Miriam Qvarnström
  • Björn Wettermark
  • Thomas KahanEmail author
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)


Adherence (or compliance) measures how well the patient takes their medication. Medication persistence measures the duration of time from initiation to discontinuation of therapy and may also consider the intensity of medication-taking behaviour within this interval. Registers on pharmacy claims data have been proposed as the golden standard in medication persistence research. Generally, persistence rate decreases with time. Medication persistence can furthermore be divided into therapy persistence and class persistence. However, these terms are usually not specifically reported in the literature, making results difficult to interpret. One third of hypertensive patients discontinue their medication within 2 years after initiation of treatment. Patient, physician, and health care organization-related factors are associated with medication persistence to antihypertensive treatment. Generally, medication persistence increases with advancing age, is higher in women than in men, and varies with comorbidities. Also, higher income, native-born citizens, and a high number of visits to the physician are all related to increased persistence. Studies on medication persistence are important, as they may be valuable tools in identifying patient groups in need of targeted interventions to improve early blood pressure control and to prevent cardiovascular complications.


Blood pressure control Drug treatment Hypertension Medication persistence Primary health care 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Miriam Qvarnström
    • 1
  • Björn Wettermark
    • 2
    • 3
  • Thomas Kahan
    • 1
    • 4
    Email author
  1. 1.Division of Cardiovascular Medicine, Department of Clinical SciencesDanderyd Hospital, Karolinska InstitutetStockholmSweden
  2. 2.Centre for Pharmacoepidemiology, Department of Medicine/SolnaKarolinska InstitutetStockholmSweden
  3. 3.Public Healthcare Services CommitteeStockholm County CouncilStockholmSweden
  4. 4.Department of CardiologyDanderyd University Hospital CorporationStockholmSweden

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