Research: Routine adherence checks needed for hypertension medication

New research to be presented at ESC Congress 2026 in Munich indicates that patients who do not take their blood pressure-lowering medications consistently may not achieve crucial cardiovascular benefits. The meta-analysis, involving patient-level data from over 91,000 participants across nine randomized trials, found that major cardiovascular disease events were significantly reduced only among patients with high adherence, defined as taking at least 80% of their prescribed treatment.

The study revealed that high adherence led to an 11% reduction in major cardiovascular events compared to a control group. In contrast, patients with lower adherence (taking less than 80% of medication) showed no significant reduction in these events. Furthermore, the research observed a decline in adherence over time, dropping from 88% in the first year to 79% by the fifth year, even within the controlled environment of clinical trials.

Presenter Qianqian Yang of the University of Oxford stated that medications cannot provide benefits if they are not taken. The findings emphasize that patients with lower adherence gain minimal to no cardiovascular benefit, while those with higher adherence experience greater blood pressure reduction and better prevention of events. The study authors and Professor Felix Mahfoud of the European Society of Cardiology are calling for routine adherence assessments and strategies to improve compliance.

Hypertension affects approximately 1.4 billion adults worldwide, and while blood pressure-lowering drugs are effective, about half of patients do not take them as prescribed. This research highlights the critical need to ensure patients adhere to their treatment regimens to realize the full protective effects of these medications.