How can we increase the efficacy of antihypertensive treatment?

Hypertension is the leading risk factor for cardiovascular diseases; however, only one-fifth of the treated population is believed to attain sufficient blood pressure control levels. A common barrier to the effectiveness of antihypertensive treatment is suboptimal adherence to medications. Non-adherence often stems from low health literacy and unawareness, complex medication regimens and asymptomatic nature of the disease itself. Increased co-morbidities of the patient and side effects of the drugs also play significant role in drug adherence problems. Another common challenge in achieving blood pressure control is therapeutic inertia, marked by the reluctance to raise drug dosage or introduce additional medications. Employing single-pill combination therapy, as recommended by the guidelines, has the potential to overcome this problem and address issues related to drug non-adherence. Novel antihypertensive drugs, which are still under development, show promise for achieving long-term blood pressure control with just a single dose. Non-pharmacological interventions, such as weight loss, low sodium intake and increased physical activity play a crucial role in achieving target blood pressure levels. In this review, key factors for improving the effectiveness of antihypertensive treatment are summarized under the headings of implementing the guideline recommendations, increasing medication compliance, encouraging lifestyle changes and future perspectives for increased treatment efficacy. We aimed to outline the strategies to overcome the global problem of insufficient blood pressure control levels in the light of latest scientific data and recommendations.