Global Prevalence of Adherence to Antihypertensives and Associated Moderating Factors Among Adults With Hypertension: A Meta-Analysis.
Reymond Ngolombe, Burnett C Chiona, Fikile Khangamwa Singano et al.
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In 30 seconds
This systematic review and meta-analysis estimated global adherence to antihypertensive medication among adults with hypertension. Across 123 studies including 1 052 445 adults, pooled adherence prevalence was 58% (95% CI, 52%-63%). Estimates varied by continent, from 45% in North America to 67% in Europe. In multivariate analysis, age and the assessment tool were the only factors significantly associated with adherence. The authors concluded that moderate to low adherence remains common and called for consensus definitions and thresholds to improve comparability across studies.
Key findings
- Pooled global adherence prevalence was 58% (95% CI, 52%-63%) across 123 studies.
- Adherence prevalence ranged from 45% in North America to 67% in Europe.
- Age and the adherence assessment tool were the only factors significantly associated with adherence in the multivariate model.
- Reported adherence categories were 39% high, 29% moderate, and 35% low.
Why it matters
Medication adherence is important to sustained blood pressure control, yet this synthesis indicates that adherence is not achieved by a substantial proportion of adults with hypertension. The variation across regions and assessment methods also highlights that prevalence estimates depend on how adherence is measured, complicating comparisons and the interpretation of the global burden.
What to keep in mind
The pooled estimate combines studies using different adherence assessment tools; the abstract reports that assessment tool was associated with adherence, indicating potential measurement-related variation.