Long-term effects of sustained regular medication in hypertensive patients in Yunnan, China: a cohort study of 5 years follow up

Abstract Background The relationship between different grades of compliance to antihypertensive medication and blood pressure(BP) control rate remains unclear. The study underscores the relationship that long-term compliance with regular antihypertensive medication to improve rates of BP control.Methods Using 5-year follow-up data, hypertensive patients were categorized into "poor", "intermittent", and " sustained" groups according to tertiles of antihypertensive medication compliance, and the BP control rates of the three groups were compared.Then, the robust variance Poisson regression model estimated the association between three groups and the number of referrals. Kaplan-Meier calculated the cumulative risk of onset and survival probability of cardiovascular events from three medication compliance groups.Results A total of 1254 patients were enrolled and annual follow-up studies of 992, 1218, 1121, 1066 and 999 hypertensive patients were conducted from 2018 to 2022. From baseline to last follow-up, systolic BP declined from 154.69 ± 20.90 mmHg to 137.48 ± 12.44 mmHg and diastolic BP from 84.08 ± 12.80 mmHg to 79.50 ± 7.88 mmHg (p < 0.01). All three groups showed a significant improvement in BP control rates after management, especially the persistence group which reached 70% in 2022(p < 0.01). The number of referrals from the poor group was 11.5% higher than the sustained group (IRR = 1.115,95% CI:1.043 to1.193). The survival probability in the sustained group was the highest and kept at 0.950 at the end of 5 years.Conclusions Long-term high-grade compliance with antihypertensive medications significantly improves BP control rates and reduces the risk of cardiovascular disease (CVD) events and death.