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Adherencia a la medicación en la comorbilidad de hipertensión y diabetes: implicaciones para el control de la
Yunyun Mei1, Hui Zhang1, Jingyou Miao1
1Department of Epidemiology and Health Statistics, Hangzhou Medical College, Hangzhou, China.
Frontiers in public health
|February 16, 2026
Resumen
La adherencia a la medicación es clave para el control de la hipertensión. La educación muestra un efecto complejo en forma de U invertida sobre la adherencia, que varía según el sexo y la diabetes, lo que pone de relieve la necesidad de intervenciones personalizadas.
Área de la Ciencia:
- Salud Pública; Epidemiología; Determinantes Sociales de la Salud
Sus antecedentes:
- La adherencia a la medicación es crucial para el manejo de la hipertensión.; No se comprenden completamente los factores sociales y conductuales que influyen en la adherencia.; El impacto de la educación y la comorbilidad de la diabetes en la adherencia requiere una mayor investigación.
Objetivo del estudio:
- Investigar los factores asociados con el control de la presión arterial y la adherencia a la medicación en pacientes hipertensos.; Analizar los efectos no lineales de la educación sobre la adherencia.; Explorar las diferencias en la adherencia según el sexo y el estado de comorbilidad.
Principales métodos:
- Muestreo aleatorio multietapa de 40.037 adultos con hipertensión en Zhejiang.; Recopilación de datos mediante cuestionarios estandarizados y registros electrónicos.; Se utilizaron modelos de regresión logística multivariante y modelos no lineales (splines cúbicos restringidos) para analizar los factores y las relaciones entre educación y adherencia.
Principales resultados:
- La adherencia a la medicación predijo significativamente el control de la hipertensión (aOR=1.35).; La adherencia fue mayor en pacientes con diabetes (aOR=1.52) y mayores ingresos.; Se observó una relación en forma de U invertida entre la educación y la adherencia, con efectos que varían según el sexo y la comorbilidad.
Conclusiones:
- La educación tiene efectos dependientes del umbral en la adherencia a la medicación, influenciados por el sexo y la diabetes.; Los patrones no lineales y específicos de subgrupos en la adherencia exigen intervenciones personalizadas.; Abordar las disparidades en el manejo de la hipertensión requiere comprender estos determinantes complejos.
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