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

Medicina

卷:57

Alina Crenguța Nicolae¹  Cristina Manuela Drăgoi¹  Alexandra Jichitu²  Vlad Alexandru Ionescu²  Elena-Codruța Dobrică³  Matei-Alexandru Cozma⁴  Camelia Cristina Diaconu⁴  Gina Gheorghe⁴  Mihnea-Alexandru Găman⁴ 

[1] Department of Biochemistry, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania;

[2] Department of Gastroenterology, Clinical Emergency Hospital of Bucharest, 14461 Bucharest, Romania;

[3] Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;

[4] Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;

关键词: polypharmacy;    hypertension;    drug interactions;    elderly;    chronic diseases;    multimorbidity;   

DOI  :  10.3390/medicina57121288

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown