When older adults take blood pressure medications as prescribed, even the most frail live longer, according to a new study from Italy.

Researchers analyzed data from 1.3 million people aged 65 and older in the Lombardy region of northern Italy who had three or more high blood pressure medication prescriptions.  They calculated the percentage of time over the next seven years or until death that each person received their medications. 

Not surprisingly, the healthiest older people benefitted the most from high medication adherence, surviving longer than those with multiple medical conditions, the researchers reported. But even the frail had an advantage if they consistently took their blood pressure drugs. Participants with high adherence were 44% less likely to die than their low-adherence peers if they started in good health; and 33% less likely to die if they started in very poor health. The same trend was seen with cardiovascular deaths. 

“Our findings definitely suggest that even in very frail people, antihypertensive treatment reduces the risk of death; however, the benefits may be smaller in this group,” said Giuseppe Mancia, M.D., from the University of Milano-Bicocca. 

Clinicians should take note, he said. 

“Do your best to encourage and support patients to take their medications, because adherence is crucial to getting the benefits,” he recommended. “Medications do nothing if people don’t take them.”

The study was published Monday in the journal Hypertension.