The Impact of Polypharmacy on Blood Pressure Achievement in Hypertensive Patients with Complications

Abstract

Hypertension is a non-communicable disease and a major risk factor for cardiovascular disease. Polypharmacy, defined as the concurrent use of multiple medications, is commonly observed in hypertensive patients, particularly those with comorbidities. Although polypharmacy may improve therapeutic outcomes, it also increases the risk of drug interactions, adverse drug reactions, and poor medication adherence, which may affect blood pressure control. This study aimed to describe the pattern of polypharmacy and evaluate its association with blood pressure target achievement among hypertensive patients. An analytical observational study with a cross-sectional design was conducted using retrospective data collected from the medical records of 75 eligible hypertensive patients. The association between polypharmacy and blood pressure target achievement was analyzed using Spearman's Rank correlation test with a 95% confidence level. The results showed that the most frequently prescribed antihypertensive regimen was a two-drug combination (25%), while the most commonly used antihypertensive class was the Angiotensin Receptor Blocker (ARB), particularly candesartan. Most patients experienced mild polypharmacy (<5 medications) (64%), followed by severe polypharmacy (>5 medications) (21.3%), whereas 14.7% did not experience polypharmacy. Only 36% of patients achieved the target blood pressure, while 64% failed to reach the target. Spearman's Rank analysis demonstrated no significant association between polypharmacy and blood pressure target achievement (p = 0.135; r = -0.174). Although no significant relationship was identified, regular evaluation of polypharmacy remains essential to minimize drug interactions and optimize therapeutic outcomes in hypertensive patients.