Compliance with antihypertensive therapy: Significance of the choice of antihypertensive drugs

Compliance with antihypertensive therapy is poor. Changes in the timing sch edule, omitted doses (so-called "drug holidays") and unauthorized ending of therapy are common patterns of behavior. It appears that forgetfulness on the one hand and a more or less "contemplated" decision on the other hand m ay both play important roles as causative factors for partial non-complianc e. Especially with the contemplated forms of non-compliance the underlying factors involved remain largely unclear. Since arterial hypertension itself may not be a symptomatic disorder, side effects of antihypertensive drugs have long been suspected to play a crucial role in the long-term adherence to antihypertensive therapy. Several large scale studies demonstrate that, indeed, compliance may differ depending on the choice of the antihypertensi ve drug. It also appears that the degree of partial or non-compliance may d irectly correlate with the side effect profile of the different antihyperte nsive drug classes. There is first evidence showing that the new class of a ntihypertensives, the angiotensin II (type 1) receptor antagonists, which a re characterized by a favorable side effect profile, may therefore be super ior to other classes of antihypertensives by enhancing long-term compliance with this treatment.