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Antihypertensive medication changes and blood pressure goal achievement in a managed care population

Journal of Human Hypertension volume 24, pages 659–668 (2010)Cite this article

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Abstract

This study examined achievement of blood pressure (BP) goals, changes in antihypertensive therapy and reasons for these changes among adults with hypertension initiating angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) or calcium channel blockers (CCBs). Claims data were examined for changes to medication regimens. Patient charts for 501 patients provided BP levels and reasons for changing medications. BP goal achievement was highest for initiators of ARBs (81.4%), compared with ACEIs (75.5%; P=NS) and CCBs (68.9%; P<0.01). Changes in antihypertensive therapy were least likely among ARB recipients (59.9%) compared with ACEIs (71.86%; P=0.02) and CCBs (74.85%; P<0.01). Failure to achieve BP goals was the most common reason for change in therapy (ARB, 32.9%; ACEI, 42.5%, P=NS; CCB, 47.9%, P<0.01). Although most patients achieved target BP goals, many required changes in treatment regimens. Initial choice of antihypertensive therapy may mitigate changes in therapies and better achieve BP goals.

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Acknowledgements

We thank Ami Sklar, Theresa Rayl, Felix Cao and Yvette Dennis for their assistance in management of the medical chart abstraction and development of the study database, and Herbert Heien for assistance in study analyses.

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Authors and Affiliations

  1. i3 Innovus, Health Economics and Outcomes, Eden Prairie, MN, USA

    N M Engel-Nitz & T Darkow

  2. Novartis Pharmaceuticals Corporation, Evidence Based Medicine, East Hanover, NJ, USA

    H Lau

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  1. N M Engel-Nitz
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  2. T Darkow
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Correspondence to N M Engel-Nitz.

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Engel-Nitz, N., Darkow, T. & Lau, H. Antihypertensive medication changes and blood pressure goal achievement in a managed care population. J Hum Hypertens 24, 659–668 (2010). https://doi.org/10.1038/jhh.2010.2

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