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Influence of Sex on Therapeutic Adherence in Cardiovascular Diseases: A Scoping Review

Guillermo Moreno1,2, Blanca Moreno-Ferreiro1, Carla Pérez-Ingidua1,3

  • 1Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain.

Journal of Clinical Medicine
|June 26, 2025
PubMed

Insights

Sex differences exist in cardiovascular disease (CVD) treatment adherence, particularly for hypertension and ischemic heart disease. Further research is needed to understand factors influencing non-adherence in both males and females.

Area of Science:

  • Cardiology
  • Public Health
  • Sex and Gender in Medicine

Background:

  • Females with cardiovascular disease (CVD) face unique challenges, including misdiagnosis and sex-related psychosocial risk factors.
  • These factors can impact treatment adherence and overall health outcomes.
  • Understanding sex differences in CVD secondary prevention is crucial.

Purpose of the Study:

  • To evaluate sex differences in adherence to secondary prevention measures for cardiovascular disease.
  • To assess risk prediction factors related to adherence in male and female CVD patients.

Main Methods:

  • A scoping review of literature was conducted using PubMed, Scopus, and Web of Science.
  • Articles published within the last five years, in English or Spanish, focusing on CVD patients were selected.
  • PRISMA guidelines and the CASPe questionnaire were used for study selection and bias assessment.

Main Results:

  • Thirteen articles were included in the review.
  • Medication adherence for hypertension showed ranges of 25-83% in males and 24-80% in females.
  • Adherence to physical activity varied, with ranges of 21-72% in males and 14-72% in females.
  • Predictive factors for adherence included older age, comorbidities, and psychosocial aspects.

Conclusions:

  • Evidence indicates sex differences in medication adherence for hypertension, ischemic heart disease, and peripheral arterial disease.
  • Further investigation is necessary to identify specific factors contributing to non-adherence in different sexes.
  • Tailored interventions may be required to improve secondary prevention adherence in cardiovascular disease patients.

Keywords:
cardiovascular diseaserisk factorssexsex inequalitiestherapeutic adherence

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