Persistence with antihypertensive drugs in patients with depression in Germany.

Abstract

The goal of the present retrospective work was to study the impact of depression on persistence with antihypertensive drugs in general practices in Germany. This study included adults with hypertension and depression who initially received antihypertensive drugs from physicians in 1,262 general practices in Germany between January 2013 and December 2015. Hypertension controls without depression were matched (1:1) to the hypertension cases with depression based on age, gender, physician, and initial antihypertensive therapy, using a propensity score method. The main outcome of the study was the rate of persistence with antihypertensive drugs in individuals with hypertension with and without depression in the 12 months following the index date. Persistence was estimated as therapy duration without treatment disruption, which was defined as at least 3 months without oral antihypertensive drugs. The effect of depression on persistence with antihypertensive treatment was analyzed in the entire population and in various subgroups using Cox regression models. The study included 24,627 hypertension patients with depression and 24,627 hypertension patients without depression. The mean age was 59.7 years (SD=12.1 years), and 37.3% were men. After 12 months of follow-up, the rate of persistence with antihypertensive therapy was 64.5% in individuals with depression and 66.9% in individuals without depression (p-value=0.232). Depression was found to have no significant impact on discontinuation in the overall population (HR=1.01, 95% CI: 0.99-1.03) or in the different subgroups (HRs ranging from 0.93 to 1.03). Depression was not significantly associated with persistence with antihypertensive drugs in Germany. .