Effects of multimorbidity and polypharmacy on blood pressure target attainment in patients with hypertension

Abstract

Background Hypertension prevalence increases with age, as well as polypharmacy and multimorbidity (P&M), which are the use of multiple medications and the presence of multiple chronic diseases, respectively. Whether P&M affects attaining blood pressure (BP) goals is not clear. Methods Hypertensive patients in the general internal medicine outpatient clinic were evaluated retrospectively. Data regarding age, gender, comorbidities, medications, office BP (OBP), home BP (HBP), and ambulatory BP (ABP) were obtained. Having two or more diseases was classified as multimorbidity, whereas using five or more drugs was classified as polypharmacy. OBP <140/90 mmHg, HBP <135/85 mmHg, and ABP <130/80 mmHg were considered BP targets. Differences in BP and attaining targets were analyzed according to P&M. Correlation analysis was also performed between BP, age, comorbidities, and medications. Results Of the 147 patients, 124 (84.4%) had multimorbidity, and 56 (38.1%) had polypharmacy. While systolic BP in OBP and HBP did not differ in the P&M groups (all p>0.05), diastolic BP was lower in patients with both (all p<0.05). Age, total number of medications, anti-hypertensive tablets, and active substance numbers showed a negative correlation with diastolic BP in both OBP and HBP (all p<0.05). There was no difference between BP goal attainments in P&M groups (p>0.05). Conclusion P&M does not affect the achievement of office and home BP targets. Lower diastolic BP with P&M does not reflect better control but reflects the effect of age on diastolic BP.

Keywords

• multimorbidity
• polypharmacy
• hypertension

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