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Large Swedish Study Finds ARBs Sustain the Best Long-Term Adherence in Hypertension

A 340,000‑patient registry analysis links superior persistence to a lower burden of side effects.

Overview

  • Researchers tracked more than 340,000 adults who began antihypertensive therapy in Sweden between 2011 and 2018, with multi‑year follow‑up reported in eClinicalMedicine.
  • Patients initiated on angiotensin receptor blockers showed the highest persistence, with about 80% maintaining good adherence at five years versus 65% for calcium channel blockers.
  • Many who discontinued their initial therapy switched to another blood pressure medication, most often to an angiotensin receptor blocker.
  • Study authors suggest the adherence advantage likely stems from fewer adverse effects, and they recommend choosing angiotensin receptor blockers first for uncomplicated cases when appropriate.
  • As an observational registry study, the analysis cannot establish causation, and a separate opinion piece citing less than half on therapy at three years and invoking U.S. 'defensive medicine' is not supported by the study’s reported figures.