IMPACT OF ANTIHYPERTENSIVE DRUG ADHERENCE ON LONG-TERM CARDIOVASCULAR OUTCOMES: A PREVENTIVE MEDICINE PERSPECTIVE

Abstract

The long-term cardiovascular outcomes strongly depend on the adherence to antihypertensive medication, which is still a common global issue that is not eliminated. This was a preventive-medicine trial that tested the relationship between the level of adherence and the occurrence of major cardiovascular events by a mixed-method design by combining quantitative clinical indicators, medication-possession ratios, the tracking of long-term outcomes, and qualitative measurement of behavioral barriers. A total cohort of hypertensive adults was assessed on high-, medium-, and low-adherence levels, and the concept of adherence was measured by means of the Medication Possession Ratio (MPR) and self-reports scales. Monitored cardiovascular outcomes, such as myocardial infarction, stroke, heart failure hospitalization, and cardiovascular mortality, were followed up over a multi-year follow-up period. Findings revealed that excellent compliance was closely linked to better blood pressure management, reduced LDL-C and fasting glucose, reduced acute cardiovascular, and significantly less mortality in the long term. On the contrary, low-adherence patients reported a much higher event rate, worse metabolic and hemodynamic status, and risk and responses in predictive modeling. A qualitative analysis of the data conducted revealed forgetfulness, medication fatigue, financial strain, and low perceived necessity as the key contributors to non-adherence. Combining clinical data with behavioral and predictive data proved that adherence is a modifiable and independent predictive variable of cardiovascular outcomes. These data support the importance of adherence-strengthening measures, such as patient education, electronic reminder tools, and simplified regimens as a solution to decrease cardiovascular morbidity and mortality that can be prevented. In general, the paper has made it clear that the optimization of the adherence to antihypertensives is one of the most effective preventive measures existing in contemporary cardiovascular medicine.