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Adherence to antihypertensives is crucial for control of blood pressure. This study analyzed factors and interventions that could affect adherence to antihypertensives in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21, 2022 and December 25, 2023 for studies on the adherence to antihypertensives in the US. Nineteen studies and 23 545 747 patients were included in the analysis, which showed that adherence to antihypertensives was the highest among Whites (OR: 1.47, 95% CI 1.34–1.61 compared to African Americans). Employment status and sex were associated with insignificant differences in adherence rates. In contrast, marital status yielded a significant difference where unmarried patients demonstrated low adherence rates compared to married ones (OR: 0.8, 95% CI 0.67–0.95). On analysis of comorbidities, diabetic patients reported lower adherence to antihypertensives (OR: 0.95, 95% CI 0.92–0.97); furthermore, patients who did not have Alzheimer showed higher adherence rates. Different BMIs did not significantly affect the adherence rates. Patients without insurance reported significantly lower adherence rates than insured patients (OR: 3.93, 95% CI 3.43–4.51). Polypill users had higher adherence rates compared with the free‐dose combination (OR: 1.21, 95% CI 1.2–1.21), while telepharmacy did not prove to be as effective. Lower adherence rates were seen among African Americans, uninsured, or younger patients. Accordingly, interventions such as fixed‐dose combinations should be targeted at susceptible groups. Obesity and overweight did not affect the adherence to antihypertensives. [ABSTRACT FROM AUTHOR]

Non-adherence is a barrier to the control of hypertension. This study aimed to analyze the factors and interventions affecting adherence rates in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21 st, 2022 for studies on the adherence to anti-hypertensives in the US. R software (4.2.1) and RevMan (5.4) were used for the analysis. Our analysis showed that non-adherence to antihypertensives was higher in Hispanics compared with Blacks (OR= 1.25, p-value= 0.0335) with further analysis showing lower non-adherence rates among Whites compared with Blacks (OR= 0.63, p-value= 0.0049). Younger individuals had higher non-adherence rates (53%) compared with individuals older than 60 (46%), however, no statistically significant difference was detected between both groups. Unemployment was associated with decreased adherence (OR= 0.40, p-value< 0.00001), while gender and marital status yielded insignificant associations. Patients who suffered from multiple comorbidities (OR= 0.43, p-value= 0.004), depression (OR= 0.65, p-value <0.00001), and poor mental health (OR= 0.38, p-value< 0.00001) had lower adherence rates. Heavy alcohol consumption was associated with a decline in adherence, conversely, obesity didn't significantly affect the adherence rates. Regarding interventions, Fixed-dose combination had lower non-adherence rates compared with the control group (OR= 0.83, p-value= 0.0029), while telepharmacy didn't prove to be as effective. Lastly, exercise was associated with higher adherence (OR= 3.08, p-value< 0.00001). Race and unemployment play a role in adherence to anti-hypertensives. Patients who suffer from depression, multiple comorbidities, and heavy alcohol intake had lower adherence rates. Accordingly, interventions such as fixed-dose combinations and exercise should be targeted at susceptible groups. [ABSTRACT FROM AUTHOR]