{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:22:06Z","timestamp":1787552526055,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Basic Clin Pharma Tox"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To estimate persistence with antihypertensive therapy (AHT) and describe treatment changes and associated factors among persistent patients over 5\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a longitudinal cohort study using the IADB.nl pharmacy database in the Netherlands, including adults who initiated AHT between 2014 and 2018 after a 2\u2010year washout. Persistence was assessed annually using a \u00b145\u2010day window around each treatment anniversary. Among patients persistent throughout follow\u2010up, treatment changes were classified yearly as no change, switching, intensification or de\u2010intensification. A Markov model estimated transitions between treatment states, and logistic regression evaluated baseline factors associated with treatment changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22\u2009027 starters (mean age 58.1\u2009years, 51.1% women), annual persistence declined from 88.8% in year 1 to 80.7% in year 5, with 52.7% remaining persistent over 5\u2009years. Treatment changes were most frequent in the first year, when 53.5% of persistent patients underwent intensification, de\u2010intensification, or switching, and declined thereafter. The probability of remaining in the same state was high, particularly for \u2018no change\u2019 state (0.86). Female sex, combination therapy initiation and initiating on beta\u2010blockers or calcium\u2010channel blockers were associated with treatment changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antihypertensive pharmacotherapy is frequently modified early after initiation, followed by increasing long\u2010term treatment stability among persistent users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcpt.70286","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:13:43Z","timestamp":1786677223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Persistence and Treatment Changes of Antihypertensive Therapy: A 5\u2010Year Cohort Study"],"prefix":"10.1111","volume":"139","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7027-7086","authenticated-orcid":false,"given":"Amal","family":"Asiri","sequence":"first","affiliation":[{"name":"Department of PharmacoTherapy, \u2010Epidemiology, and \u2010Economics University of Groningen  Groningen the Netherlands"},{"name":"Department of Pharmacy Practice, Faculty of Pharmacy King Abdulaziz University  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-1061","authenticated-orcid":false,"given":"Sumaira","family":"Mubarik","sequence":"additional","affiliation":[{"name":"Department of PharmacoTherapy, \u2010Epidemiology, and \u2010Economics University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9209-7564","authenticated-orcid":false,"given":"Jens H. 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