Department of Health Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd.
S Afr Fam Pract (2004). 2022 Jun 29;64(1):e1-e10. doi: 10.4102/safp.v64i1.5434.
Hypertension (HTN) is the most significant risk factor for cardiovascular disease (CVD) in South Africa (SA), with one in three people over the age of 25 suffering from HTN. Whilst human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) are the leading causes of death in South Africa, CVD is in the top 10 causes of death, demonstrating the importance of detecting and controlling blood pressure early on. This study aimed to review adherence factors to antihypertensive medication and antiretroviral therapy (ART) and evaluate the resulting factors influencing adherence discrepancies within the South African population.
A comprehensive literature review was carried out. PubMed, ScienceDirect, Cochrane and Embase were searched for English publications between 2000 and 2021.
A total of 50 articles covering quantitative and qualitative studies were included. Many studies identified poor adherence levels to antihypertensive treatment, reaching a substandard adherence rate of 41.9%, whilst most studies on the HIV-positive population reported good levels of adherence, with adherence rates of more than 90%. Being of the male gender, advanced age, low socioeconomic status and a low level of education were associated with unsatisfactory adherence rates in both groups. Within the HIV group, more participants had better knowledge concerning the extent of their disease and its required treatments.
The results present substandard adherence levels to antihypertensives compared with antiretroviral (ARV) adherence, despite the influence of more non-adherence factors in the HIV group. The authors recommend better adherence counselling for patients with HTN during every clinic visit, regular healthcare worker training and the implementation of ART adherence programmes in patients with hypertension.
高血压（HTN）是南非（SA）心血管疾病（CVD）最重要的危险因素，每三个 25 岁以上的人中就有一人患有 HTN。虽然人类免疫缺陷病毒和获得性免疫缺陷综合征（HIV/AIDS）是南非的主要死亡原因，但 CVD 是十大死因之一，这表明早期检测和控制血压非常重要。本研究旨在综述抗高血压药物和抗逆转录病毒治疗（ART）的依从性因素，并评估导致南非人群依从性差异的因素。
进行了全面的文献回顾。在 2000 年至 2021 年间，在 PubMed、ScienceDirect、Cochrane 和 Embase 上搜索了英语出版物。
共纳入 50 篇涵盖定量和定性研究的文章。许多研究发现抗高血压治疗的依从性水平较差，达到了 41.9%的标准以下，而大多数关于 HIV 阳性人群的研究报告了良好的依从性水平，依从率超过 90%。在两性中，男性、年龄较大、社会经济地位较低和教育程度较低与两组的依从性差有关。在 HIV 组中，更多的参与者对疾病的严重程度及其所需的治疗有更好的了解。
与抗逆转录病毒（ARV）依从性相比，结果显示抗高血压药物的依从性标准较低，尽管 HIV 组中存在更多的不依从因素。作者建议在每次就诊时为高血压患者提供更好的依从性咨询，定期对医护人员进行培训，并在高血压患者中实施 ART 依从性方案。
