Antihypertensive Medication Use, Adherence, Stops, and Starts in Canadians With Hypertension

Background: Some of the greatest barriers to achieving blood pressure control are perceived to be failure to prescribe antihypertensive medication and lack of adherence to medication prescriptions. Methods: Self-reported data from 6017 Canadians with diagnosed hypertension who responded to the 2008 Canadian Community Health Survey and the 2009 Survey on Living with Chronic Diseases in Canada were examined. Results: The majority (82%) of individuals with diagnosed hypertension reported using antihypertensive medications. The main reasons for not taking medications were either that they were not prescribed (42%) or that blood pressure had been controlled without medications (45%). Of those not taking antihypertensive medications in 2008 (n = 963), 18% had started antihypertensive medications by 2009, and of those initially taking medications (n = 5058), 5% had stopped. Of those taking medications in 2009, 89% indicated they took the medication as prescribed, and 10% indicated they occasionally missed a dose. Participants who were recently diagnosed, not measuring blood pressure at home, not having a plan to control blood pressure, or not receiving instructions on how to take medications were less likely to be taking antihypertensive medications; similar factors tended to be associated with stopping antihypertensive medication use. Conclusions: Compatible with high rates of hypertension control, most Canadians diagnosed with hypertension take antihypertensive medications and report adherence. Widespread implementation of self-management strategies for blood pressure control and standardized instructions on antihypertensive medication may further optimize drug treatment.