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.

中文翻译：

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美国抗高血压药物的依从性：对 2300 万患者的比较荟萃分析

坚持服用抗高血压药物对于控制血压至关重要。这项研究分析了美国可能影响抗高血压药物依从性的因素和干预措施。 PubMed、Scopus、Web of Science 和 Embase 于 2022 年 1 月 21 日和 2023 年 12 月 25 日检索了有关美国抗高血压药物依从性的研究。分析中纳入了 19 项研究和 23 545 747 名患者，结果表明白人对抗高血压药物的依从性最高（与非裔美国人相比，OR：1.47，95% CI 1.34-1.61）。就业状况和性别与依从率的无显着差异相关。相反，婚姻状况存在显着差异，未婚患者的依从率低于已婚患者（OR：0.8，95% CI 0.67-0.95）。根据合并症分析，糖尿病患者报告抗高血压药物依从性较低（OR：0.95，95% CI 0.92-0.97）；此外，没有患有阿尔茨海默病的患者表现出更高的依从率。不同的BMI并没有显着影响依从率。没有保险的患者报告的依从率显着低于有保险的患者（OR：3.93，95% CI 3.43-4.51）。与自由剂量组合相比，Polypill 使用者的依从率更高（OR：1.21，95% CI 1.2-1.21），而远程用药并没有被证明有效。非裔美国人、未投保或年轻患者的依从率较低。因此，固定剂量组合等干预措施应针对易感人群。肥胖和超重并不影响抗高血压药物的依从性。