After the diagnosis: adherence and persistence with hypertension therapy.

Poor adherence to therapy is a major reason that large percentage of patients with hypertension fail to achieve good blood pressure control. Side effects, such as cough, dizziness, nausea, and headache, are frequently cited as reasons for lack of adherence and persistence with hypertension therapy. Use of newer classes of antihypertensive agents with better tolerability than older agents may be one way to improve adherence and persistence. Recent studies have shown higher rates of adherence and persistence with therapy in patients treated with angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, or newer calcium channel blockers compared with other antihypertensive agents. Health insurance coverage can also affect patient adherence and persistence.