Risco de Desfechos Adversos à Saúde em Pacientes com Baixa Adesão ao Tratamento Medicamentoso Cardiovascular: uma Revisão Sistemática

Marcus Vinícius Bolívar Malachias; Sergio Emanuel Kaiser; Denilson Campos de Albuquerque; Andréa Araujo Brandão; Andrei C. Sposito; Lidia Zytynski Moura; Lucélia Batista Neves Cunha Magalhães; Marco Antonio Mota-Gomes; Nadine Clausell; Paulo César Veiga Jardim; Wilson Nadruz; Bruno Monteiro Barros; Leonardo Castro Luna; Weimar Kunz Sebba Barroso

doi:10.1590/SciELOPreprints.9997

##article.authors##

Marcus Vinícius Bolívar Malachias Faculdade de Ciências Médicas de Minas Gerais https://orcid.org/0000-0002-8171-3920
Sergio Emanuel Kaiser Universidade do Estado do Rio de Janeiro
Denilson Campos de Albuquerque D’Or Institute for Research and Education
Andréa Araujo Brandão Universidade do Estado do Rio de Janeiro
Andrei C. Sposito Universidade Estadual de Campinas (UNICAMP)
Lidia Zytynski Moura Pontifícia Universidade Católica de Curitiba
Lucélia Batista Neves Cunha Magalhães Faculdade Zarns
Marco Antonio Mota-Gomes Centro Universitário Cesmac
Nadine Clausell Hospital de Clínicas de Porto Alegre
Paulo César Veiga Jardim Hospital do Coração
Wilson Nadruz Universidade Estadual de Campinas (UNICAMP)
Bruno Monteiro Barros Instituto Nacional de Cardiologia
Leonardo Castro Luna Instituto Nacional de Cardiologia
Weimar Kunz Sebba Barroso Universidade Federal de Goiás

DOI:

https://doi.org/10.1590/SciELOPreprints.9997

Keywords:

medication adherence, patient compliance, Cardiovascular diseases

Abstract

Background: Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Medication adherence is an important issue in managing chronic CVD, directly influencing outcomes and healthcare costs.

Objectives: This systematic review, supported by the Brazilian Society of Cardiology, evaluates the impact of poor adherence to cardiovascular medications on critical clinical outcomes such as death and cardiovascular events.

Methods: A comprehensive search was conducted across four databases, including Medline, Embase, Lilacs, and the Cochrane Library. The review included systematic reviews with meta-analyses that reported risk estimates for adherence to cardiovascular medications. Four systematic reviews, each incorporating observational studies, were selected.

Results: The principal findings indicate that an increase in adherence to medications significantly reduces the risk of cardiovascular events, stroke, and all-cause death. Specifically, a 20% improvement in adherence to antihypertensive, lipid-lowering, and other cardiovascular medications correlated with reductions in cardiovascular events by 7%, 10%, and 9%, respectively; stroke by 17%, 13%, and 18%; and death by 12%, 9%, and 10%. The certainty of the evidence was moderate, suggesting that these effects are likely present. These findings emphasize the importance of enhancing medication adherence to improve clinical outcomes in CVD management.

Conclusions: Evidence has demonstrated reductions in hard endpoints in both primary and secondary prevention through the control of conditions such as hypertension and elevated LDL cholesterol concentrations, as well as the benefits of antiplatelet therapy in atherosclerotic disease. However, additional studies are needed to better elucidate the relationship between adherence to cardiovascular medications and the improvement of critical clinical outcomes.