Background:
Multimorbidity, defined as the presence of ≥ 2 chronic disorders, has become the norm in many countries as populations age. It remains, however, very infrequently researched. This study evaluated the factors associated with multimorbidity in a predominantly Chinese hypertensive population.
Methods:
We included all adult patients prescribed their first antihypertensive agents in the public sector of the entire Hong Kong population from a validated clinical database. Multinomial regression analyses were performed to explore factors independently associated with multimorbidity.
Results:
223,286 hypertensive patients (average age of 59.9 years, SD 17.6) were included. The prevalence of having 0, 1 and ≥2 additional chronic conditions was 59.6% [133,176/223,286], 32.8% [73,313/223,286] and 7.5% [16,797/223,286], respectively. Older age (>50 years), male sex, lower household income, receipt of comprehensive social security allowance and suboptimal blood pressure control (>140mmHg or >90mmHg; >130mmHg or >80mmHg for diabetes patients; AOR=3.38 to 4.49) were significantly associated with the presence of ≥2 additional conditions. There exists a synergistic effect among these variables as older (≥70 years), male patients receiving security allowance had substantially higher prevalence of ≥2 multimorbidity (19.9% vs 7.5% among all patients).
Conclusions:
Multimorbidity is very common in hypertensive patients and its prevalence increased markedly with the presence of risk factors identified in this study. Hypertensive patients with multimorbidities should receive more meticulous clinical care as their blood pressure control tends to be poorer.
Contribution of poor blood pressure control to strokes.
