{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:38:06Z","timestamp":1792647486760,"version":"4.5.0"},"reference-count":153,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Hypertension is a significant public health issue affecting over a billion adults worldwide with adherence to antihypertensives being crucial for achieving sustained blood pressure control and reducing cardiovascular morbidity and mortality. To extend previous evidence, we conducted a meta\u2010analysis on global prevalence of adherence to antihypertensives among adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A systematic search was conducted in Scopus, PubMed, Web of Science, Embase, and CINAHL. Pooled prevalence of antihypertensive medication adherence was estimated using generalized linear mixed\u2010effects model in R software version 4.4.3. Cochran's Q, \u03c4\n                      <jats:sup>2<\/jats:sup>\n                      , and\n                      <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                        <mml:semantics>\n                          <mml:mrow>\n                            <mml:msup>\n                              <mml:mi>I<\/mml:mi>\n                              <mml:mn>2<\/mml:mn>\n                            <\/mml:msup>\n                          <\/mml:mrow>\n                          <mml:annotation encoding=\"application\/x-tex\">$$ {I}^2 $$<\/mml:annotation>\n                        <\/mml:semantics>\n                      <\/mml:math>\n                      statistics examined statistical heterogeneity with moderator analysis exploring sources of heterogeneity. Sensitivity analysis was analyzed using exact fixed\u2010effects model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 123 studies with 1\u2009052\u2009445 adults with hypertension were included. Pooled global prevalence of adherence to antihypertensives was estimated at 58% (95% CI, 52%\u201363%), with 39% for high adherence, 29% for moderate adherence, and 35% for low adherence. Results for sensitivity analysis were 57.91% (95% CI, 57.81%\u201358.01%) with \u03b4\u0302 being 24.3%. Prevalence across continents was 67% for Europe, 65% for South America, 60% for Africa, 56% for Asia, and 45% for North America. Adherence to antihypertensives was similar across low\u2010income countries (61%), high\u2010income countries (58), upper\u2010middle\u2010income countries (57%), and lower\u2010middle\u2010income countries (56%). In multivariate model, age and assessment tool only were significantly associated with medication adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Globally, a large proportion of adults with hypertension exhibit moderate to low adherence to antihypertensive medications. Future studies should prioritize establishing consensus\u2010based operational definitions and cutoff values to enhance adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047824","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:27:08Z","timestamp":1792150028000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Global Prevalence of Adherence to Antihypertensives and Associated Moderating Factors Among Adults With Hypertension: A Meta\u2010Analysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7624-5297","authenticated-orcid":false,"given":"Reymond","family":"Ngolombe","sequence":"first","affiliation":[{"name":"National Taipei University of Nursing and Health Sciences","place":["Taipei, Taiwan"]},{"name":"Mzimba District Hospital","place":["Mzimba, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burnett C.","family":"Chiona","sequence":"additional","affiliation":[{"name":"St John's Institute for Health","place":["Mzuzu, Malawi"]},{"name":"Taipei Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3072-9324","authenticated-orcid":false,"given":"Fikile","family":"Khangamwa Singano","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences","place":["Lilongwe, Malawi"]},{"name":"University of Wisconsin\u2013Milwaukee","place":["Milwaukee, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5009-4012","authenticated-orcid":false,"given":"Frank","family":"Sinyiza","sequence":"additional","affiliation":[{"name":"Mzuzu Central Hospital","place":["Mzuzu, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizwani B.","family":"Chilinda","sequence":"additional","affiliation":[{"name":"Independent Researcher","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8714-5530","authenticated-orcid":false,"given":"Tsae\u2010Jyy","family":"Wang","sequence":"additional","affiliation":[{"name":"National Taipei University of Nursing and Health Sciences","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0244-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-024-01622-w"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-1989-1745"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-020-00427-x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.935135"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5603\/KP.2019.0018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.120.15026"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.14236"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S498537"},{"key":"e_1_3_2_11_2","first-page":"3028","article-title":"Medication adherence: its importance in cardiovascular outcomes","volume":"119","author":"Ho PM","year":"2009","unstructured":"Ho PM, Bryson CL, Rumsfeld JS. 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