Psychosocial Support as a Multidisciplinary Asset in Hypertension Care: A Systematic Review of Medication Adherence, Blood Pressure Outcomes, and Social Context Exposures.

BACKGROUND: Hypertension remains a major global health challenge that requires care strategies extending beyond pharmacological treatment. Psychosocial support may contribute to long-term self-management, medication adherence, and care coordination, but evidence remains dispersed across different support domains, social-context exposures, settings, and outcome measures. This systematic review aimed to synthesize recent evidence on psychosocial support, adverse social-context exposures, medication adherence, and blood pressure outcomes among adults with hypertension. METHODS: This systematic review followed the PRISMA 2020 statement. A systematic search was conducted in PubMed, Scopus, and selected EBSCOhost databases for English-language empirical studies published from January 2021 to February 2026. Studies were included if they examined direct psychosocial support resources, structured support interventions, or related adverse social-context exposures among adults with hypertension and reported quantitative medication adherence or blood pressure outcomes. Data were synthesized using a structured narrative approach. RESULTS: Eighteen studies involving 25,639 participants from 12 countries were included. Direct psychosocial support was generally associated with better medication adherence, although the strength and consistency of evidence varied across study designs, support definitions, measurement instruments, and analytical approaches. Evidence on blood pressure outcomes was less consistent. Some studies reported associations between low support or adverse social contexts and uncontrolled blood pressure, while intervention studies showed mixed findings. Adverse social-context exposures, including living alone, socio-familial risk, limited social contact, and cumulative social adversity, appeared distinct from direct psychosocial support and showed varying associations with hypertension management outcomes. CONCLUSION: Psychosocial support appears to be an important community and multidisciplinary care resource for hypertension management, particularly in supporting medication adherence. Routine psychosocial assessment should be integrated into hypertension care pathways involving nurses, physicians, pharmacists, and community health workers. Future research should use longitudinal and controlled intervention designs with standardized measures to clarify how partnership-driven care models improve adherence and long-term blood pressure outcomes.