OBJECTIVES: To evaluate treatment persistence in patients receiving fixed-dose combinations or unfixed combinations with olmesartan medoxomil (OLM) or valsartan (VAL) for hypertension treatment in Germany. METHODS: This retrospective study analyzed prescription data collected by general practitioners, using a longitudinal database, the German IMS Disease Analyzer (DA). The DA database was searched for patients with hypertension (ICD-10 code I10) who were initiated on OLM or VAL in double combinations with hydrochlorothiazide (HCT) or amlodipine (AML) in the period 09/2008 to 08/2009 with a follow-up of at least 12 months. Persistence was defined as proportion of patients who remained on their initially prescribed therapy at 1 year. RESULTS: In total, 2882 patients were eligible for analysis (1079 patients receiving OLM, thereof 75.2% with fixed-dose combinations; 1803 patients receiving VAL, thereof 88.5% with fixed combinations). 12 months after the first prescription, more patients receiving OLM stayed on their initial therapy compared to VAL: unfixed combination with AML 27.4% vs. 25.2%; fixed-dose combination with AML 47.3% vs. 44.6%; unfixed combination with HCT 25.0% vs. 13.7%; fixed-dose combination with HCT 44.6% vs. 39.6%. Mean duration of persistence in patients receiving OLM compared to VAL group was: 183.6 [SD 163.5] days vs. 181.2 [SD 159.8] days in unfixed combinations with AML; 235.7 [SD 167.8] days vs. 234.6 [SD 165.0] days in fixed-dose combinations with AML; 184.0 [SD 155.4] days vs. 123.4 [SD 138.9] days in unfixed combinations with HCT; 228.5 [SD 167.8] days vs. 222.9 [SD 165.6] days in fixed-dose combinations with HCT. CONCLUSIONS: Overall, findings based on real-life prescription data suggest better patient persistence with unfixed and fixed-dose OLM combinations compared to respective VAL combinations. In terms of persistance not all angiotensin receptor blockers perform equal rather hint at patient-individual treatment. Further research is needed to confirm these first results.