High blood pressure patients who don't take their medications are at major risk of medical complications, according to a new report in the journal Circulation. 

Sure, drug therapy can be exensive and have bothersome side effects.  Medical skeptics invoke Big Pharma conspiracy theories to impugn physician motives for prescribing.  But there's little doubt that blood pressure drugs are effective in reducing rates of cardiovascular events such as heart attacks, strokes, and cardiac deaths.

Italian primary care physicians followed almost 19,000 newly diagnosed high blood pressure patients over the course of five years.  Average age was 62 and they were free of heart disease and strokes at baseline.  One or more drugs for daily use were prescribed.  Adherence to the medication regimen was noted as either high (taking the drugs at least eight of every 10 days), intermediate (taking drugs four to eight of every 10 days), or low (taking drugs less than four of every 10 days). 

Guess how many patients were in the low adherence group . . . . . . . . . . half of them!  Compliance may not be much different in the U.S. 

Compared with the low adherence group, the high adherence group had 38% fewer cardiovascular events such as heart attacks, chest pain, strokes, and heart-related deaths. 

The lesson is clear: If you have high blood pressure and want to reduce the associated medical risks, take your drugs. 

-Steve Parker, M.D.

References: 

Mazzaglia, G., et al.  Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients.  Circulation, 120 (2009): 1598-1605.  Published online ahead of print October 5, 2009

Lowry, Fran.  High adherence to antihypertensive therapy lowers cardiovascular risk.  TheHeart.org, October 9, 2009.