Ramipril plus amlodipine and ramipril plus hydrochlorothiazide fixed-dose combinations in relation to patient adherence

Objective To compare 1-year treatment adherence of ramipril+amlodipine and ramipril+hydroclorothiazide fixed-dose combination therapies in patients with hypertension. Methods Data were extracted from the database of the National Health Insurance Fund of Hungary. Treatment adherence was modelled using survival analysis. Results At 2 months after initiation of treatment, 42% of patients using ramipril+hydrochlorothiazide (n=28,800) had discontinued treatment, compared with 0% of patients using ramipril+amlodipine (n=10,295). At 1 year, treatment adherence was 29% in the ramipril+hydrochlorothiazide group and 54% in the ramipril+amlodipine group. The hazard ratio for discontinuing ramipril+hydrochlorothiazide vs ramipril+amlodipine was 2.318 (95% confidence intervals 2.246, 2.392). Conclusion Ramipril+amlodipine had significantly higher 1-year treatment adherence than ramipril+hydrochlorothiazide in patients with hypertension.