Medication adherence in vascular prevention: findings from the SIFHON-ADH survey in Argentina

Stroke remains a leading cause of death and disability globally, accounting for approximately 11.6% of deaths, and a major contributor to global morbidity [1].In Argentina, about 2% of adults older than 40 years have experienced a cerebrovascular event [2].Recurrent cerebrovascular and cardiovascular events occur in 5-13% of survivors, further increasing disability and mortality risks [3].Effective secondary prevention including control of vascular risk factors and pharmacotherapy reduces recurrent event risk [4].However, success largely depends on patient adherence to medication regimens [5].Real-world adherence in Latin America is poorly characterised, complicated by socioeconomic, cultural, and healthcare system differences [6][7][8].Studies report variable adherence rates, ranging from approximately 65% in stroke survivors in Chile to significant discontinuation among Argentine patients on anticoagulation [9].Adherence is influenced by education, economic factors, cognitive status, and healthcare access [10].Recent systematic reviews and meta-analyses confirm persistent gaps in adherence across cardiovascular conditions and support the effectiveness of multicomponent and digital/mHealth strategies to improve adherence [11][12][13][14].This study aims to evaluate medication adherence rates and associated factors among Argentine adults in primary (vascular risk without prior events) and secondary (post-vascular event) prevention groups, addressing critical gaps in regional adherence data.Methods.Population and sampling.Two groups of participants were recruited.The Primary Prevention Group (PPG) included adults aged 18 years or older with hypertension, diabetes, overweight or obesity, and/or dyslipidaemia, but without a prior history of stroke or myocardial infarction.The Secondary Prevention Group (SPG) included adults aged 18 years or older with a documented clinical history of ischaemic or haemorrhagic stroke, transient ischaemic attack, or acute myocardial infarction.Participants in the SPG were recruited from an institutional ischaemic stroke cohort database and had been admitted between 2017 and 2020.Participants in the PPG were recruited through a consumer database provided by a leading national beverage distribution company, which distributes still and sparkling water across Argentina.We had previously collaborated with this company in survey-based projects and for the present study; they facilitated access to their mailing distribution platform, allowing us to reach a large number of individuals for inclusion in the primary prevention group.Group allocation was determined based on self-reported medical history.