Wehling Martin
Department of Clinical Pharmacology, Faculty of Clinical Medicine Mannheim, Heidelberg University, Mannheim, Germany.
Clin Ther. 2004;26 Suppl A:A21-7. doi: 10.1016/s0149-2918(04)90142-7.
Poor compliance with treatment and early discontinuation negatively affect long-term blood pressure control. According to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, poor compliance could contribute to the lack of adequate blood pressure control in approximately 70% of patients with hypertension, even after treatment with several antihypertensive drugs.
This article discusses blood pressure control and patient compliance with antihypertensive drugs. It then outlines the clinical pharmacokinetics and interaction profile of the novel antihypertensive olmesartan medoxomil, an angiotensin II receptor antagonist (AIIRA), and relates the findings to the recommended dosing regimen and tolerability of the drug.
Many factors influence patient compliance, including forgetfulness, adverse effects, irregular lifestyle, and complexity of drug regimen, such as multiple drugs and, in particular, frequent dosing. Drugs that are well tolerated and easy to manage in a once-daily regimen improve compliance. In a study of different classes of antihypertensive drugs, patients taking AIIRAs were more likely to continue their treatment than those taking any other class of antihypertensive. Therefore, the right drug choice may contribute to patient compliance. The newest member of the AIIRAs, olmesartan medoxomil, is a long-acting antihypertensive drug with a favorable safety and tolerability profile. It is not metabolized by and does not interfere with the cytochrome P-450 enzyme system. These properties meet modern requirements for the treatment of hypertension.
