Abstract:
A newly released large-scale study shows that antihypertensive drugs can effectively reduce the risk of heart disease and stroke, but only if patients insist on taking them regularly as prescribed by their doctor. If you frequently miss doses, even if you are receiving treatment, the cardiovascular protective effect of the drug may be greatly reduced or even close to disappearing.
This study was announced at the 2026 European Society of Cardiology Annual Meeting. Researchers point out that currently approximately 1.4 billion adults aged 30 to 79 worldwide suffer from hypertension. Because hypertension often lacks obvious symptoms, many patients have difficulty recognizing the dangers of the disease in their daily lives. However, long-term high blood pressure can continue to damage blood vessels and organs, increasing the risk of coronary heart disease, stroke, heart failure and other diseases.
While antihypertensive medications have been shown to significantly reduce these risks, the reality is less than ideal. Researchers say about half of patients don't keep taking their medications exactly as prescribed, which may be undermining the health benefits the drugs are supposed to have.
In order to accurately evaluate the importance of taking medications regularly, a research team from the University of Oxford in the UK pooled and analyzed data from 9 randomized clinical trials, involving a total of 91,339 subjects. Unlike many previous analyzes based on observational studies, randomized trials can more effectively eliminate other interfering factors and thus more truly reflect the impact of medication compliance on treatment effects.
The researchers divided the participants into two categories: one group took at least 80% of the prescribed dose and was defined as a high-adherence group; the other group took less than 80% of the prescribed dose and was classified as a low-adherence group. The results show that even in highly regulated clinical trial settings, patient adherence to medication declines over time. In the first year, 88% of patients were highly compliant, but by the fifth year this had dropped to 79%.
Further analysis showed that patients who persisted in taking the medication achieved significantly better antihypertensive effects. In the high-adherence group, antihypertensive treatment reduced systolic blood pressure by an average of 5.2 mmHg; in the low-adherence group, this amount was only 3.0 mmHg.
A more important difference is in the risk of cardiovascular disease. The research team focused on serious cardiovascular events such as stroke, myocardial infarction, ischemic heart disease, and heart failure leading to hospitalization or death. The results found that among those who insisted on taking medications regularly, the incidence of major cardiovascular events was 11% lower than that in the control group; while among those who often missed taking medications, the study did not observe a significant risk reduction effect.
The leader of the study said that this result shows that prescribing antihypertensive drugs is only part of the treatment. Whether the patient can adhere to the medication for a long time also determines whether the treatment can truly protect the heart and blood vessels. For the management of hypertension, improving patient medication compliance should become an important direction for the future medical system to focus on.
The researchers believe that in future clinical practice, we should not only pay attention to patients' blood pressure values, but also more actively monitor their medication status, and take measures such as reminders, education, and digital management to help patients establish long-term regular medication habits.
Experts point out that many patients stop taking medication intermittently because their symptoms are not obvious, they feel they are in good health, or they are worried about side effects. But the biggest danger of high blood pressure lies precisely in its hidden nature. Even if patients feel normal, vascular damage and cardiovascular risks may continue to accumulate. This study further proves that antihypertensive drugs can provide significant protection, but this protection is based on continuous and regular taking of the drugs, rather than simply having a prescription for the drug itself.
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