Table 5.
Logistic regression of discontinuation among 45 954 initiators with at least one year of follow‐up
| Discontinuation of initial therapy | Discontinuation of all antihypertensive therapy | |||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted | Adjusted† | Unadjusted | Adjusted† | |||||
| OR (95% CI) | P‐value | OR (95% CI) | P‐value | OR (95% CI) | P‐value | OR (95% CI) | P‐value | |
| First‐line therapy | ||||||||
| Monotherapy (recommended) | 1.00 (Ref) | <0.001 | 1.00 (Ref) | <0.001 | 1.00 (Ref) | <0.001 | 1.00 (Ref) | <0.001 |
| Monotherapy (not recommended)† | 2.71 (2.54–2.91) | 2.01 (1.86–2.17) | 3.37 (3.18–3.58) | 2.64 (2.47–2.83) | ||||
| Fixed‐dose combination (antihypertensives) | 1.48 (1.34–1.62) | 1.20 (1.09–1.32) | 1.73 (1.59–1.88) | 1.42 (1.30–1.55) | ||||
| Multiple antihypertensives | 3.90 (3.42–4.46) | 2.70 (2.36–3.10) | 1.15 (1.04–1.26) | 0.81 (0.73–0.89) | ||||
| Not initiating on lowest recommended dose * | 2.15 (2.05–2.26) | <0.001 | 1.70 (1.61–1.79) | <0.001 | 1.92 (1.85–2.01) | <0.001 | 1.62 (1.55–1.70) | <0.001 |
| Initiating on a “potentially harmful” comorbidity‐antihypertensive combination | 2.27 (2.08–2.47) | <0.001 | 1.26 (1.14–1.40) | <0.001 | 2.18 (2.03–2.34) | <0.001 | 1.13 (1.04–1.24) | 0.006 |
| Year of initiation | ||||||||
| 2008/09 | 0.99 (0.93–1.05) | 0.18 | 1.01 (0.94–1.07) | 0.37 | 0.96 (0.90–1.01) | 0.04 | 0.99 (0.94–1.06) | 0.19 |
| 2009/10 | 1.04 (0.97–1.11) | 1.04 (0.98–1.11) | 1.02 (0.96–1.09) | 1.04 (0.98–1.11) | ||||
| 2010/11 | 1.00 (0.94–1.07) | 1.01 (0.94–1.08) | 1.04 (0.98–1.10) | 1.05 (0.98–1.12) | ||||
| 2011/12 | 0.96 (0.90–1.02) | 0.98 (0.91–1.04) | 0.97 (0.91–1.03) | 0.99 (0.93–1.06) | ||||
| 2012/13 | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
| Age | ||||||||
| 18–49 years | 2.08 (1.96–2.22) | <0.001 | 1.89 (1.77–2.02) | <0.001 | 2.97 (2.80–3.14) | <0.001 | 2.72 (2.56–2.89) | <0.001 |
| 50–59 years | 1.22 (1.15–1.31) | 1.19 (1.11–1.27) | 1.47 (1.38–1.56) | 1.43 (1.34–1.52) | ||||
| 60–69 years | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
| 70–79 years | 1.04 (0.99–1.09) | 1.05 (1.00–1.11) | 0.99 (0.94–1.04) | 1.00 (0.95–1.06) | ||||
| 80+ years | 1.17 (1.10–1.25) | 1.15 (1.08–1.24) | 1.28 (1.20–1.37) | 1.27 (1.18–1.35) | ||||
| Sex | ||||||||
| Male | 1.00 (Ref) | 0.54 | 1.00 (Ref) | 0.84 | 1.00 (Ref) | 0.37 | 1.00 (Ref) | <0.001 |
| Female | 1.01 (0.97–1.05) | 1.00 (0.96–1.05) | 0.98 (0.95–1.02) | 0.93 (0.90–0.97) | ||||
| Number of medicines dispensed in year prior | ||||||||
| Quartile 1 (1–2) | 1.00 (Ref) | 0.009 | 1.00 (Ref) | <0.001 | 1.00 (Ref) | <0.001 | 1.00 (Ref) | <0.001 |
| Quartile 2 (3–4) | 0.95 (0.90–1.01) | 1.01 (0.95–1.07) | 0.94 (0.89–0.99) | 0.99 (0.94–1.05) | ||||
| Quartile 3 (5–7) | 0.92 (0.87–0.97) | 1.01 (0.95–1.07) | 0.95 (0.90–1.00) | 1.04 (0.98–1.10) | ||||
| Quartile 4 (≥8) | 0.99 (0.94–1.05) | 1.13 (1.05–1.22) | 1.06 (1.00–1.11) | 1.21 (1.13–1.30) | ||||
| Medicines dispensed for treatment of: | ||||||||
| Angina | 1.16 (1.03–1.29) | 0.01 | 1.27 (1.13–1.43) | <0.001 | 1.04 (0.93–1.15) | 0.52 | 1.25 (1.13–1.40) | <0.001 |
| Depression | 1.04 (0.99–1.09) | 0.10 | 0.91 (0.87–0.96) | <0.001 | 1.14 (1.09–1.20) | <0.001 | 0.94 (0.90–0.99) | 0.02 |
| Diabetes | 0.81 (0.76–0.87) | <0.001 | 0.87 (0.82–0.94) | <0.001 | 0.92 (0.86–0.97) | 0.006 | 0.98 (0.91–1.05) | 0.49 |
| Gastro‐oesophageal reflux disease | 0.97 (0.92–1.01) | 0.10 | 1.00 (0.95–1.05) | 0.89 | 0.93 (0.89–0.97) | <0.001 | 0.96 (0.92–1.01) | 0.11 |
| Gout | 0.85 (0.77–0.95) | 0.003 | 0.89 (0.80–0.99) | 0.04 | 0.83 (0.74–0.92) | <0.001 | 0.86 (0.77–0.96) | 0.007 |
| Heart failure | 0.86 (0.79–0.93) | <0.001 | 0.90 (0.82–0.98) | 0.02 | 0.93 (0.85–1.00) | 0.06 | 1.06 (0.97–1.16) | 0.18 |
| Hyperlipidaemia | 0.75 (0.72–0.78) | <0.001 | 0.82 (0.78–0.86) | <0.001 | 0.74 (0.71–0.77) | <0.001 | 0.84 (0.80–0.88) | <0.001 |
| Obstructive airway disease | 1.02 (0.97–1.07) | 0.51 | 0.99 (0.94–1.05) | 0.80 | 1.02 (0.98–1.07) | 0.32 | 0.99 (0.94–1.04) | 0.66 |
*
Adjusted for all variables in the table.
†
Beta‐blockers without any indication for their use, or thiazide diuretics in <65 years.