Systemic arterial hypertension represents the most prevalent morbidity among adults, affecting an estimated 30% of the xxxx population. Its predominantly asymptomatic course contributes to delayed diagnosis and constitutes a major challenge for health systems, particularly regarding adherence to prescribed therapeutic regimens. Current estimates indicate that fewer than half of hypertensive individuals achieve satisfactory medication adherence, resulting in suboptimal blood pressure control and heightened risk of adverse cardiovascular outcomesTo identify and synthesize evidence on interventions that enhance adherence to pharmacological treatment for systemic arterial hypertension.An integrative literature review was conducted using SciELO, PubMed, and BVS/LILACS databases, targeting studies published between 2015 and 2025. Inclusion criteria comprised full-text articles in Portuguese, Spanish, or English that addressed strategies to promote medication adherence within the context of Primary Health Care. Eight studies met the eligibility criteria and were subjected to qualitative synthesis.The selected studies demonstrated consistent evidence that multiprofessional follow-up, electronic reminder technologies, structured health education, and the strengthening of patient–provider relationships were associated with improved adherence. Interventions integrating digital tools and ongoing counseling appeared particularly effective in sustaining long-term treatment engagement. Based on the synthesized evidence, a protocol adapted to local health system conditions was developedThe reviewed studies exhibited substantial methodological heterogeneity, including variability in research designs, sample sizes, and adherence assessment instruments. Most samples were small and limited to local settings, restricting external validity. A scarcity of controlled clinical trials and multicenter investigations was noted, alongside a predominance of descriptive designs and isolated interventions, which hampers long-term impact evaluation. The studies highlight notable strengths: diverse, context-sensitive strategies in primary care, creative team adaptability despite structural constraints, and the transformative impact of group education and case-management practices driven by strong patient–provider relationships and continuous communication.The findings underscore the practical applicability of evidence-based strategies to enhance treatment adherence in Primary Health Care settings. These approaches may inform the planning and implementation of continuous and resolutive care actions for individuals with hypertension, while reinforcing permanent health education and longitudinal monitoring within the xxxx Unified Health System.