1. Introduction
Advances in diagnostic and therapeutic strategies have improved ischemic
heart disease (IHD) outcomes over the last decades.1Particularly, the use of evidence-based pharmacological therapy (β
blockers, renin-angiotensin-aldosterone system blockers, statins, and
antiplatelet drugs) has been demonstrated to improve long-term prognosis
by reducing mortality by up to 40%, stabilizing disease progression,
reducing the risk of recurrence, and enhancing functional
capacity.2,3 Nonetheless, despite these advancements,
IHD remains the leading cause of morbidity and mortality in countries of
all income groups,4 reflecting the suboptimal
implementation of secondary prevention strategies and subsequent burden
on global healthcare services. Likewise, the use of such medications is
still low, with a nonadherence prevalence ranging from 40 to
80%,5 exhibiting health disparities among countries
and socioeconomic status.4 In this context, most
available data on medication adherence proceeds from developed countries
and clinical trials,6 which may not reflect the actual
situation of developing countries, especially in those with higher
income-health inequalities. Thus, medication-taking behavior may require
national consensus and individualized tools to address the problem in a
population-based manner to overcome socioeconomic, cultural, and ethnic
barriers. Although data exist on medication adherence for secondary
prevention of cardiovascular disease (CVD) in developing countries, to
the best of our knowledge, no study has explored potential reasons for
nonadherence in Mexico. This study aimed to determine the level of
adherence to secondary prevention therapy in patients with IHD and
dyslipidemia in the National Institute of Cardiology ”Ignacio Chávez”
and identify the key barriers contributing to medication nonadherence.