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Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association
Open accessAbstract
The widespread treatment of hypertension and resultant improvement in blood pressure have been major contributors to the dramatic age-specific decline in heart disease and stroke. Despite this progress, a persistent gap remains between stated public health targets and achieved blood pressure control rates. Many factors may be important contributors to the gap between population hypertension control goals and currently observed control levels. Among them is the extent to which patients adhere to prescribed treatment. The goal of this scientific statement is to summarize the current state of knowledge of the contribution of medication nonadherence to the national prevalence of poor blood pressure control, methods for measuring medication adherence and their associated challenges, risk factors for antihypertensive medication nonadherence, and strategies for improving adherence to antihypertensive medications at both the individual and health system levels.
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“Single-pill antihypertensive combinations may improve medication-taking behavior in some individuals (60,61).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [60]
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Race and Patient-Physician Communication on Blood Pressure Management: Helping Improve Care
Nasser, S. A., Pender, A., Ali, A., Tobb, K., & Ferdinand, K. C. (2026) · Current Cardiology Reports · doi:10.1007/s11886-025-02294-9
“To improve adherence, and in consideration of low health literacy, individualized and repeated clinician and pharmacist-led education interventions should be initiated at the time of diagnosis [39 , 40 ].”
Self-citationEditorial: The newer paradigms in hypertension research and management
Marwaha, K., Norris, K. C., & Mody, F. V. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1781466
Nurosmala, Iskandar, A., Pratama, K. N., & Yulianto, P. (2026) · Journal multidisciplinary science · doi:10.59631/multidiscience.v3i1.467
“Hypertension, also known as high blood pressure, refers to a condition in which blood pressure exceeds normal thresholds (Choundhry et al., 2022).”
Ullah, A., Ahmad, I., & Deng, W. (2026) · Diagnostics · doi:10.3390/diagnostics16020244
Sudarman, S., Dioso, R., Hassan, H. C., Asfar, A., & Matdoan, R. A. (2025) · JURNAL PENDIDIKAN KEPERAWATAN INDONESIA · doi:10.17509/jpki.v11i2.89827
“Yet, even where effective pharmacotherapy is available, medication nonadherence and suboptimal self-management remain persistent barriers that substantially undermine blood pressure (BP) control (Choudhry et al., 2022).”
Asuhan Keperawatan Pada Pasien Hipertensi Dengan Terapi Tawa Untuk Menurunkan Tekanan Darah
Rahmawati, L., Wijayanti, S., Faradisa, E., & Setyorini, D. (2025) · Jurnal Ilmiah Kesehatan Mandala Waluya · doi:10.54883/jikmw.v5i2.1373
“Faktor Gaya Hidup: Perubahan tekanan darah dapat dipengaruhi oleh berbagai faktor gaya hidup, termasuk konsumsi kafein, tingkat aktivitas fisik, kualitas tidur, dan tingkat stres (Choudhry et al., 2022).”
Yu, R. L., & Zeng, X. (2025) · Community Mental Health Journal · doi:10.1007/s10597-025-01574-6
“Factors such as managing multiple chronic conditions (Fix et al., 2014; Kronish et 2017; Liddy et al., 2014), cognitive deficits (Choudhry et al., 2022 ), financial strain (Weinfeld et al., 2021), substance use (Kronish et al., 2017), and social determinants like housing (Gu et al., 2023 ; Office…”
Heath, E., Almosa, A., Joseph, R., & Appiah, D. (2025) · Healthcare · doi:10.3390/healthcare13182303
“…to treatment for hypertension has been reported to be suboptimal among vulnerable populations like the homeless and people with low-income status [20], controlled hypertension was used as a proxy for current use of hypertension medication, and it was defined as having blood pressure 130/80 mmHg…”
Pediatric hypertension: a toolkit for optimizing lifestyle and pharmacologic adherence
Walsh, A. T., Yohannan, T., Harvey, E., Hussain, A., Parashar, N., Sahni, D., Carroll, C., & Philip, R. R. (2025) · Exploration of Medicine · doi:10.37349/emed.2025.1001350
Huang, T., Bai, L., Li, H., Shen, P., Lin, H.-B., Li, H., Wang, Z., Xu, Y., Shi, L.-W., & Guan, X. (2025) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2025.08.009
New Drugs for Resistant Hypertension: Pending Issue?
Fici, F., Robles, N. R., Tengiz, I., & Grassi, G. (2025) · Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır · doi:10.5543/tkda.2025.74304
Closing gaps in blood pressure control: a look at two major approaches
Nesbitt, S. D. (2025) · Exploration of Medicine · doi:10.37349/emed.2025.1001337
Cheng, L., Bai, N., Zheng, L., Cao, L., Wu, H., Wang, R., Zhao, C., Shen, Y., Zhao, H., Li, G., et al. (2025) · JMIR Research Protocols · doi:10.2196/79158
Hypertensive patients: self-care experience in rural community
Susanto, J., Makhfudli, M., Ilkafah, I., Tyas, A. P. M., Yusuf, A., & Iswatun, I. (2025) · International Journal of Public Health Science (IJPHS) · doi:10.11591/ijphs.v14i2.24171
“These inhibiting factors are significantly related to treatment adherence [39].”
Detection and Follow-Up of Hypertension and Synopsis of Guideline Recommendation
Jones, K. M. (2025) · Nephrology Self-Assessment Program · doi:10.58483/nsap.00032025
Nguyen, N., Le, S. D. T., Bui, H. T., Hoàng, V., & Do, C. C. (2025) · Medicine · doi:10.1097/md.0000000000041744
Dhafin, A. A., Putri, E. M., Mawarni, O. I., Probosiwi, N., Laili, N., Ilmi, T., & Wahdi, A. (2025) · JOURNAL OF COMMUNITY ENGAGEMENT IN HEALTH · doi:10.30994/jceh.v8i1.711
“Compliance with taking antihypertensive drugs is one of the factors that contributes to uncontrolled blood pressure in hypertensive patients (Niteesh K. Choudhry, MD et al., 2022).”
Zhen, H. U., Wang, X., Zheng, C., Cao, X., Tian, Y., Gu, R., Cai, J., Ye, T. I. A. N., & Wang, Z. (2025) · 老年心脏病学杂志：英文版 · doi:10.26599/1671-5411.2025.03.007
Yao, Y., Zhang, X., Ye, R., Jia, S., Yang, X., & Chen, X. (2025) · Trials · doi:10.1186/s13063-025-08719-8
Posttreatment Blood Pressure as a Key Predictor in a 5‐Year Stroke Prediction Model
Zhang, N., Mei, J., Fan, F., Zhang, Y., Zhou, Z., & Li, J. (2025) · Journal of Clinical Hypertension · doi:10.1111/jch.14974
“In practice, traditional cohort studies face challenges in accurately determining medication adherence and consistently collecting long-term posttreatment BP data in patients with hypertension [11, 12].”
Ma, M., Wang, H., Pang, L., Guo, Z., Sun, M., Zhao, Y., Shi, Y., Wu, X., Song, J., Zhu, Q., et al. (2025) · International Journal of Hypertension · doi:10.1155/ijhy/4505824 · Cited by 1
Bates, N., Hunter, J., Patil, S. P., & Tumin, D. (2025) · Journal of Clinical and Preventive Cardiology · doi:10.4103/jcpc.jcpc_45_24
Hida, Y., Imamura, T., & Kinugawa, K. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13195879
Medication adherence in the elderly: A comprehensive review
Samajdar, S., Tripathi, R., Venkatraman, S., Mukherjee, S., Pal, J., Tripathi, S., Joshi, S. R., & Maheshwari, A. (2024) · National Journal of Pharmacology and Therapeutics · doi:10.4103/njpt.njpt_60_24
Shukla, S., Hiremath, N., Sarkar, A., Mirajkar, A., Hiremath, J., Nyamagoud, S., & Swamy, A. H. V. (2024) · International Journal of Pharmaceutical Investigation · doi:10.5530/ijpi.14.2.63
“…considered by physicians while treating chronic illness as an increase in pill counts results in patient non-compliance to medications, our study showed that polypharmacy is statistically associated with medication adherence at p =<0.005 which is similar to the study conducted by Niteesh et al , 20”
InfluentialAzizi, M. (2024) · Bulletin de l Académie Nationale de Médecine · doi:10.1016/j.banm.2023.10.005
Brotons, C., Camafort, M., Castellanos, M. D. M., Clará, A., Cortés, O., Rodríguez, Á. D., Elosúa, R., Gorostidi, M., Hernández, A., Herranz, M., et al. (2023) · Nefrología · doi:10.1016/j.nefroe.2023.08.001
Metadata
- Authors
- Choudhry, N. K., Kronish, I. M., Vongpatanasin, W., Ferdinand, K. C., Pavlik, V. N., Egan, B. M., Schoenthaler, A., Houston Miller, N., Hyman, D. J., & on behalf of the American Heart Association Council on Hypertension; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology
- ORCID
- Venue
- Hypertension
- Published
- 2022-01
- Volume
- 79
- Issue
- 1
- Pages
- e1-e14
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC11485247
- OpenAlex
- W3204423521
- Cited by
- 349
- References
- 119
- Citations by year
- 2026: 89 · 2025: 68 · 2024: 62 · 2023: 85 · 2022: 41
- FWCI
- 52.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01 HS026522)
- National Heart, Lung, and Blood Institute (R25HL105444)
- National Institute on Minority Health and Health Disparities (R01MD013769)
- 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
- medication adherence, medication non-adherence, blood pressure control, antihypertensive drugs, adherence measurement, risk factors for non-adherence, adherence interventions, health system interventions, cardiovascular disease prevention
- MeSH terms
- American Heart Association, Antihypertensive Agents, Blood Pressure, Humans, Hypertension, United States, Medication Adherence
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