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TOPLINE:

Patients with untreated or uncontrolled hypertension who started antihypertensive monotherapy in the first month after diagnosis were more likely to achieve blood pressure (BP) control at 6 months than those who started treatment later. Although this BP control was sustained for 30 months, hypertension remained uncontrolled in more than 30% of patients at 3 years.

METHODOLOGY:

• Researchers conducted a secondary analysis of a limited dataset to evaluate the effect of initiating antihypertensive monotherapy within the first month after a diagnosis of hypertension.
• They included 15,422 adults with newly diagnosed and untreated hypertension (mean age, 56 years; mean systolic BP, 153.3 mm Hg; 55.4% women) between January 2019 and January 2023 using data from electronic medical record systems of five healthcare organizations or from data warehouses.
• Untreated hypertension was defined as having a BP ≥ 140/90 mm Hg at the initial visit without any previous prescription of antihypertensive medications.
• Treatment initiation referred to a new prescription of antihypertensive medication.
• Hypertension control was defined as having a BP < 140/< 90 mm Hg.

TAKEAWAY:

• Treatment was started in approximately 44% of patients within the first month, in 75% at 6 months, in 82% at 1 year, and in 90% at 2 years after the diagnosis of hypertension.
• Hypertension control at 6 months after diagnosis was achieved by a higher proportion of patients who started treatment in the first month than those who initiated treatment at later timepoints (57.4% vs 47.5%; P < .001), with effects being maintained till 30 months (66.8% vs 62.0%; P < .001).
• During the study period of 42 months, patients who started treatment during the first month of diagnosis were 21% more likely to achieve hypertension control (adjusted hazard ratio, 1.21; 95% CI, 1.15-1.27) than those who remained untreated during the first month.
• Starting treatment during the first month was also beneficial in achieving the hypertension control threshold < 130/< 80 mm Hg.

IN PRACTICE:

“For both clinical outcomes and care quality metrics, controlling hypertension within the first 6 months after diagnosis is important,” the study authors wrote.

SOURCE:

This study was led by Robert B. Barrett, the American Medical Association in Greenville, South Carolina. It was published online on April 21, 2025, in Hypertension.

LIMITATIONS:

This study relied on electronic health records, which often provide incomplete or inconsistent data, particularly when integrating data from various healthcare organizations. Data on medication prescriptions may have been incomplete or inaccurate. BP measurements may have been subjected to errors in usual care settings.

DISCLOSURES:

This study received no specific funding. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.