NEW YORK (Reuters Health) - A Canadian study confirms that better adherence to blood pressure-lowering therapy is associated with a reduced risk of disease of the blood vessels and, especially, the arteries that supply the brain.

In a report in the journal Stroke, Dr. Sylvie Perreault of McGill University, Montreal, and colleagues note that the benefits of blood pressure-lowering, or "antihypertensive," therapy on major cardiovascular outcomes have been demonstrated in clinical trials.

However, in actual practice, about half of patients with hypertension (high blood pressure) do not adhere well to their prescribed therapy.

To examine the impact of adherence in the real world, the researchers examined data on more than 83,000 hypertensive patients. They were between 45 and 85 years old, initially free of cardiovascular disease, and were newly treated for hypertension between 1999 and 2004.

In all, there were 1301 strokes and other "cerebrovascular" events in the first year, and 2264 subsequently. The researchers matched each case with 15 randomly chosen control subjects.

After adjusting for factors that might influence the results, the team found that those with adherence rates of at least 80 percent had a 22 percent reduced risk of cerebrovascular events. However, this was only true after a year, confirming that there is delay before the benefit becomes apparent.

Given the importance of adherence to drug therapy, the investigators conclude, "greater attention should be paid to this aspect, which may result in improved patient outcome."

SOURCE: Stroke, January 2009.

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