Missing doses of blood pressure medicine may weaken its protection against heart attacks, strokes and other serious cardiovascular problems, which affect the heart and blood vessels. Researchers presented the findings at ESC Congress 2026. Their analysis covered 91,339 participants in nine clinical trials, which compared blood pressure treatment with either a pill containing no active medicine or less intensive treatment.
Participants were divided according to how consistently they took their assigned medicine. Those who took at least 80% were placed in the higher-adherence group, meaning they followed treatment more closely. The proportion reaching this level fell from 88% in the first year to 79% in the fifth year, despite regular checks during the trials.
Among participants who followed treatment more closely, blood pressure fell more. Their treatment group also had 11% fewer major cardiovascular events than the comparison group, including heart attacks and strokes. Among those who took less than 80% of their medicine, the analysis found no statistically clear reduction in these events.
The researchers recommend routine checks on medicine use, better patient education and practical support. Suggested approaches include simpler schedules, several medicines combined in one pill, and longer-acting drugs that may limit the effects of an occasional missed dose. They also stress the importance of open conversations about difficulties with taking medicine.
