Prevalence and determinants of alcohol use disorder and its association with adherence to antihypertensive therapy among adult hypertensive patients in a hospital setting, Northwest Ethiopia

BackgroundAlcohol use disorder (AUD) is a major public health problem that contributes to poor treatment adherence and adverse clinical outcomes. Evidence on its impact on adherence to antihypertensive therapy remains limited in low-resource settings, including Ethiopia. This study assessed the prevalence of AUD and its association with adherence to antihypertensive medication among hypertensive adults.Methods A hospital-based cross-sectional study was conducted among hypertensive outpatients at the University of Gondar Comprehensive and Specialized Hospital from January 30 to May 30, 2024. Participants were selected using simple random sampling. Alcohol use disorder was assessed using the Alcohol Use Disorders Identification Test (AUDIT) and medication adherence was evaluated over a three-month period. Bivariable and multivariable logistic regression analyses identifed factors associated with AUD and non-adherence to antihypertensive therapy. Statistical significance was set at p < 0.05.Results A total of 400 participants were included (response rate: 100%), with a mean age of 44.9 ± 12.5 years. The prevalence of AUD was 12.2%, comprising hazardous drinking (8.0%), harmful use (2.5%), and alcohol dependence (1.7%). Male sex (AOR = 3.60; 95% CI: 1.30–9.94), cigarette smoking (AOR = 8.56; 95% CI: 3.89–18.82), and comorbidities (AOR = 3.87; 95% CI: 1.75–8.56) were independently associated with AUD. Overall, 42.2% of participants were non-adherent to antihypertensive therapy. Alcohol dependence was associated with nearly fourfold higher odds of poor adherence compared with social drinking.Conclusion AUD is common among hypertensive patients and is significantly associated with poor adherence to antihypertensive therapy. Integrating alcohol use screening and intervention into routine hypertension care may improve medication adherence and treatment outcomes.