Hypertension is a leading non-communicable disease both globally and in Saudi Arabia. Poor adherence to antihypertensive medications remains a major challenge in managing this condition, contributing to higher morbidity, mortality, and healthcare costs. This study aimed to review and synthesize the literature on factors contributing to medication nonadherence among hypertensive patients in Saudi Arabia. A structured literature review was conducted using the PubMed and Scopus databases. Inclusion criteria include English-language studies conducted in Saudi Arabia from 2010 to 2024 involving hypertensive adult Saudi patients. A total of 84 studies were identified. Eleven studies met the final inclusion criteria. All were cross-sectional studies using different validated adherence assessment tools. Adherence rates varied widely, from 33% to 86.1%, influenced by the choice of measurement tool and regional differences. Higher adherence was associated with older age, female gender, higher education level, being married, and higher income. Psychosocial and behavioral factors, including beliefs about the necessity of medication, perceived social support, and strong physician-patient relationships, positively influenced adherence. One study using the Health Belief Model (HBM) found that perceived severity, susceptibility, benefits, and cues to action significantly affected adherence behaviors. Medication adherence among hypertensive patients in the Saudi population is influenced by a complex relationship of demographic, psychosocial, and healthcare-related factors. Addressing these elements through tailored interventions and appropriate assessment tools may enhance hypertension management outcomes.
