Polypharmacy in the Management of Arterial Hypertension-Friend or Foe?

Background and Objectives: Polypharmacy is associated with drug-drug or food-drug interactions that may pose treatment difficulties. The objective of the study was to investigate the use of polypharmacy in hypertensive patients hospitalized in the Internal Medicine Clinic of a European referral hospital. Materials and Methods: We conducted a retrospective chart review study on patients identified by a database search of discharge diagnoses to assess the use of polypharmacy and identify potential drug-drug and food-drug interactions. Results: In total, 166 hypertensive patients (68.46 +/- 12.70 years, range 42-94 years) were compared to 83 normotensive subjects (67.82 +/- 14.47 years, range 22-94 years) who were hospitalized in the clinic during the same period. Polypharmacy was more common in hypertensive versus normotensive subjects (p = 0.007). There were no differences in terms of age, as well as major (0.44 +/- 0.77 versus 0.37 +/- 0.73 interactions/patient, p = 0.52) and minor (1.25 +/- 1.50 versus 1.08 +/- 1.84 interactions/patient, p = 0.46) drug-drug interactions between patients with and without hypertension. The mean number of drug-drug interactions (6.55 +/- 5.82 versus 4.93 +/- 5.59 interactions/patient, p = 0.03), moderate drug-drug interactions (4.94 +/- 4.75 versus 3.54 +/- 4.17, p = 0.02) and food-drug interactions (2.64 +/- 1.29 versus 2.02 +/- 1.73, p = 0.00) was higher in patients with hypertension versus their counterparts. Conclusions: The present study reinforces that polypharmacy is a serious concern in hypertensive patients, as reflected by the high number of potentially harmful drug-drug or food-drug interactions. We recorded higher numbers of comorbidities, prescribed drugs, and moderate drug-drug/food-drug interactions in hypertensive versus normotensive patients. A strategy to evaluate the number of discharge medications and reduce drug-drug interactions is essential for the safety of hypertensive patients.

Automated summary

This study found that polypharmacy is more common in hypertensive patients hospitalized in a European referral hospital, leading to a higher number of potential drug interactions. Compared to normotensive patients, hypertensive patients often have more comorbidities, prescribed drugs, and moderate drug interactions.