SynthesisJournal of the American Heart Association2025
High Burden and Trend in Nonadherence to Blood Pressure-Lowering Medications: Meta-Analysis of Data From Over 34 000 Adults With Hypertension in Sub-Saharan Africa.
Synthesis in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- A systematic review of medication adherence and mortality in chronic disease: Implications for clinical guidelines and policy.British journal of clinical pharmacology · 2026Pooled it
- Disease risk perception, health intervention intention and their influencing factors among prehypertensive and hypertensive populations: a cross-sectional study with 1050 participants.BMC public health · 2026Article
- Acceptability of Hypertension Quality Indicators in Primary Care in South Africa: Exploratory Implementation Research.Healthcare (Basel, Switzerland) · 2026Article
- A Summary of Cardiometabolic Disorders in the Maghreb: Insights from the 2025 Saclay Cardiometabolic Summit.Cardiology and therapy · 2026Review
- Overcoming variable response in renal denervation: Key strategies for reliable clinical implementation.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Review
- Association between physical activity and blood pressure control among Moroccan adults with hypertension.Frontiers in sports and active living · 2026Article
- The survival penalty: Age-based inequities in hypertension and diabetes management in African health systems (1990-2022) - a secondary quantitative analysis.PLOS global public health · 2026Article
- Therapeutic Adherence in Cardiovascular Diseases: Insights from the Patient and Physician-A Narrative Review.Advances in therapy · 2026Review
- Assessment of Adherence to Medication and Its Association with Health-Related Quality of Life Among Hypertensive Patients in the United Arab Emirates.Patient preference and adherence · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonadherence to blood pressure (BP)-lowering medication is a strong predictor of poor BP control. Sub-Saharan Africa has extremely low BP control rates (~10%), but it is unclear what the burden of medication nonadherence among Africans with hypertension is. This systematic review estimated the prevalence and determinants of nonadherence to BP-lowering medications in Sub-Saharan Africa. METHODS AND
resultsMultiple databases were searched from inception to December 6, 2023. Two reviewers performed independent screening, extraction, and quality assessment of studies. We pooled the prevalence estimates using random effects meta-analyses and summarized the determinants using a narrative synthesis. From the 1307 records identified, we included 95 studies published between 1995 and 2023. The overall prevalence of nonadherence to BP-lowering medication among 34 102 people treated for hypertension in 27 countries was 43.9% (95% CI, 39.2-48.6). There was no change in the prevalence of nonadherence over time. Nonadherence varied by measurement method and by median age (39.4%, ≥57 years versus 47.9%, <57 years). Socioeconomic and patient-related factors were the most frequent factors influencing adherence. Active patient participation in management, accurate perceptions, and knowledge of hypertension and its treatment predicted good medication adherence, whereas high pill burden, medication cost, side effects, and comorbidities predicted poor adherence.
conclusionsTwo out of every 5 people are nonadherent to their BP treatment. With the African population projected to increase from 1.4 to ~2.5 billion by 2050, targeted strategies are urgently needed to optimize medication adherence in people with hypertension in Sub-Saharan Africa.
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