Multiple Drug Intolerance Syndrome and Arterial Hypertension-Systematic Review and Meta-Analysis

Background: Arterial hypertension (HT) is one of the most prevalent diseases, causing increased morbidity and mortality. Treatment of HT might be complicated by multiple drug intolerance syndrome (MDIS), defined as intolerance to three or more drug classes. This systematic review and meta-analysis aimed to assess the prevalence of MDIS in patients with hypertension and investigate its impact on disease control. Materials and Methods: MEDLINE, Scopus, Web of Science, and Embase were thoroughly searched in June 2024. The data concerning MDIS prevalence, MDIS risk factors, number of adverse drug reactions (ADRs), and types of reactions was extracted. Quality assessment was done with the use of the Newcastle-Ottawa Scale. Meta-analysis was conducted to determine the pooled prevalence of MDIS and ADRs. The study was conducted according to the PRISMA guidelines. Results: This review included four studies (2508 patients). The pooled prevalence of MDIS was 10% (95% CI: 4%-19%). Headache was the most frequent ADR reported in the studies (71.47%, 95% CI: 56.5%-84.44%), while pain in other body parts was present in 53.08% of patients. Female sex was found to increase the risk of MDIS in each included study. Other risk factors identified were older age, gastrointestinal disorders, anxiety disorders, panic attacks, and depression. Blood pressure was higher in the MDIS group, and in this group, more patients had uncontrolled hypertension. Conclusions: The prevalence of MDIS in the hypertensive population can be considered high. Furthermore, blood pressure control is worse in patients with MDIS. However, this phenomenon is still studied inadequately, and further research is necessary.