Objective  To analyze medication adherence rates among hypertensive patients in mainland China from 2006 to 2016 and to provide evidences for developing appropriate public health strategies to increase medication adherence of the patients.

  Methods  We searched PubMed database, China National Knowledge Infrastructure database, WanFang Database, VIP Database, supplemented by literature retrospective method, to collect literatures on medication compliance of among community hypertensive patients in mainland China from January 1, 2006 to December 31, 2016; then we conducted a meta-analysis with Stata 12.0 software.

  Results  A total of 19 studies were included, involving 44 322 participants. Among the participants, the pooled medication adherence rate was 42.5% (95% confidence interval 95% CI: 37.4% – 47.6%). The medication adherence rate was statistically higher in the urban patients than in the rural patients (44.5% vs. 38.9%, χ² = 57.254, P < 0.001). The medication adherence rates were 36.9%, 40.6%, and 47.9% among the hypertensive patients in north-eastern, eastern, and central-western China, respectively, with a significant difference (χ² = 316.846, P < 0.001). The pooled medication adherence rate for the studies published between 2006 and 2011, was significantly lower than that (45.3%) for the studies published between 2012 and 2016 (χ² = 68.852, P < 0.001); the medication adherence rate pooled based on the studies of high quality was significantly lower than that pooled based on the studies of moderate and low quality (40.5% vs 50.8%, χ² = 33.095; P < 0.001). There was no statistically significant publication bias for the included studies based on Begg′s test and Egger′s test (both P > 0.05).

  Conclusion  The medication adherence is poor among hypertensive patients in mainland China, suggesting that further studies are needed to explore related factors of medication adherence for developing targeted interventions on increasing medication adherence rate in hypertensive patients.