Sex differences in adherence to antihypertensive treatment in patients aged above 55: The French League Against Hypertension Survey (FLAHS)

Despite the availability of efficient therapies to reduce the risk of cardiovascular complications, poor adherence to antihypertensive (anti‐HTN) drugs is frequent, especially during the first year of treatment and among uncontrolled/resistant hypertensive patients. The aim of the study was to identify factors associated with adherence to anti‐HTN treatment and to examine whether they differ across sex. A total of 2743 treated hypertensive participants to the cross‐sectional Metascope survey (France, 2015) aged 55 years or more were included. The authors measured adherence to anti‐HTN treatment using the 6‐item Girerd compliance test. Variations in adherence were examined using the Rao‐Scott statistics and Poisson regression. Overall, 63.6% of participants were adherent to anti‐HTN treatment. Adherence was more frequent among women than men (69% vs 58%, P < 10−4). For both sexes, level of adherence was positively associated with age (P < 10−4), but inversely associated with number of anti‐HTN tablets, number of tablets taken for metabolic diseases, history of cardiovascular diseases, number of other chronic diseases (all P < 10−4). The inverse relationship between adherence and the number of anti‐HTN tablets significantly differed between sexes (P < 10−4): Adherence decreased sharply when taking two or more anti‐HTN tablets in men, whereas the decrease in women was only observed when taking three or more anti‐HTN tablets. This study suggests that adherence to anti‐HTN treatment is higher among women, decreases with the number of tablets prescribed, and differentially so across sex. Reducing the number of tablets for anti‐HTN treatment may improve adherence, especially among men and patients with multiple comorbidities.