Adherence in Hypertension: A Review of Prevalence, Risk Factors, Impact, and Management
Abstract
The global epidemic of hypertension is largely uncontrolled and hypertension remains the leading cause of noncommunicable disease deaths worldwide. Suboptimal adherence, which includes failure to initiate pharmacotherapy, to take medications as often as prescribed, and to persist on therapy long-term, is a well-recognized factor contributing to the poor control of blood pressure in hypertension. Several categories of factors including demographic, socioeconomic, concomitant medical-behavioral conditions, therapy-related, healthcare team and system-related factors, and patient factors are associated with nonadherence. Understanding the categories of factors contributing to nonadherence is useful in managing nonadherence. In patients at high risk for major adverse cardiovascular outcomes, electronic and biochemical monitoring are useful for detecting nonadherence and for improving adherence. Increasing the availability and affordability of these more precise measures of adherence represent a future opportunity to realize more of the proven benefits of evidence-based medications. In the absence of new antihypertensive drugs, it is important that healthcare providers focus their attention on how to do better with the drugs they have. This is the reason why recent guidelines have emphasize the important need to address drug adherence as a major issue in hypertension management.
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Many different methods of assessing adherence to hypertensive treatment have been described in the literature.
“Many different methods of assessing the adherence to hypertensive treatment have been described in the literature.12”
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- Authors
- Burnier, M., & Egan, B. M.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- University of South Carolina (US)
- Venue
- Circulation Research
- Published
- 2019-03-29
- Volume
- 124
- Issue
- 7
- Pages
- 1124-1140
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- OpenAlex
- W2943413777
- Cited by
- 878
- References
- 16
- Citations by year
- 2026: 165 · 2025: 133 · 2024: 120 · 2023: 152 · 2022: 140 · 2021: 105 · 2020: 54 · 2019: 7 · 2016: 1
- FWCI
- 78.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- hypertension, medication adherence, non-compliance, blood pressure control, antihypertensive therapy, electronic monitoring, biochemical monitoring, cardiovascular risk, socioeconomic factors, patient factors
- MeSH terms
- Antihypertensive Agents, Blood Pressure, Humans, Hypertension, Practice Patterns, Physicians', Risk Factors, Treatment Outcome, Practice Guidelines as Topic, Guideline Adherence, Medication Adherence
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