Age-specific differences in hypertension combination management and associated factors influencing treatment choice

Area of Science:

• Cardiology
• Internal Medicine
• Pharmacology

Background:

• Current hypertension guidelines advocate for combination therapy, especially single-pill combination therapy (SPC).
• Limited research exists on the prevalence and influencing factors of initial therapy choices across diverse age groups in contemporary populations.
• Understanding age-specific treatment patterns is crucial for optimizing hypertension management.

Purpose of the Study:

• To compare the prevalence and factors associated with initial combination therapy, including SPC, among young, middle-aged, and older adult hypertensive patients.
• To identify specific patient subgroups who are less likely to receive recommended combination therapies.

Main Methods:

• A retrospective study identified 964 treatment-naïve hypertensive patients from January 2019 to January 2020.
• Patients were categorized into young (<55 years), middle-aged (55–64 years), and older (≥65 years) groups.
• Multivariable regression analysis was employed to determine factors associated with combination therapy use within each age group.

Main Results:

• Only 20% of patients received SPC, with prevalence decreasing with age.
• Younger patients (<55) without prior catheterization or echo tests were less likely to receive multiple therapies.
• Older male patients (≥65) with lower weight and lower cardiovascular risk were also less likely to receive combination therapy.

Conclusions:

• Combination therapy, particularly SPC, is underutilized in the studied hypertensive population.
• Young patients lacking specific cardiac investigations and lower-risk older males represent key populations potentially neglected in combination therapy initiation.
• Findings can inform targeted interventions to improve the use of SPC and optimize hypertension care resource allocation.