OBJECTIVES: To evaluate persistence and compliance of fixed dose combinations in comparison to unfixed dose combinations of angiotensin receptor blockers (ARBs) in patients with hypertension 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 double or triple combinations of ARBs with hydrochlorothiazide (HCT) and/or amlodipine (AML) in the period 09/2008-08/2009 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. The difference between mean persistence values (days) were calculated by using multiple regression analyses adjusted by age, gender, region, insurance and co-morbidity. Compliance was measured indirectly based on the medication possession ratio calculated as number of days supplied within the refill interval in relation to the number of days in the refill interval. RESULTS: Overall, 17,310 patients were eligible for analysis: 35.7% on a fixed double ARB combination, 33.0% on an unfixed double ARB combination, 25.9% on a semi-fixed triple ARB combination, and 5.4% on an unfixed triple ARB combination. Twelve months after first prescription persistence on unfixed versus semi-fixed ARB/HCT+AML triple combination was 32.7% and 46.7 % respectively, unfixed versus semi-fixed ARB/AML+HCT triple combination was 41.5% and 49.0% respectively, unfixed versus fixed ARB/HCT double combination 23,8% and 41.1% respectively, unfixed versus fixed ARB/AML double combination 27.5% and 44.4% respectively. Mean days of persistence was higher in patients receiving fixed combinations (225.7-242.9) compared to unfixed combinations (163.6-228.0). Mean compliance value with fixed combinations ranged between 72.0%-79.0%, with unfixed combinations between 71.5-76.2%. CONCLUSIONS: These real-life data confirms previous study results, that fixed combinations improve persistence in patients compared to unfixed combinations because of reduced pill burden.