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Cardiovascular-Related Polypharmacy and Its Association with Liver and Kidney Function: A Cross-Sectional Study Using

Caroline Trin1, Harvey Jia Wei Koh1,2, Zhomart Orman1,2

  • 1PharmacoEpidemiology Research Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Alfred Precinct, Melbourne, VIC, 3004, Australia.

Drugs & Aging
|April 29, 2026
PubMed

Insights

Cardiovascular disease (CVD) polypharmacy is common in patients on lipid-lowering therapy and linked to older age and multiple health conditions. This polypharmacy is associated with kidney dysfunction, indicating a need for careful prescribing.

Area of Science:

  • Pharmacology
  • Nephrology
  • Geriatrics

Background:

  • Polypharmacy is prevalent in patients with cardiovascular disease (CVD), increasing risks of adverse outcomes like kidney and liver dysfunction.
  • This study investigates the link between CVD polypharmacy and kidney/liver dysfunction in patients on lipid-lowering therapy in Australia.

Purpose of the Study:

  • To examine the association between CVD-related polypharmacy and biochemical indicators of kidney and liver dysfunction.
  • To identify predictors of CVD-related polypharmacy in patients prescribed lipid-lowering therapy.

Main Methods:

  • Retrospective cross-sectional study using electronic medical records (2013-2022).
  • CVD polypharmacy defined as >5 concurrent cardiovascular medications.
  • Kidney dysfunction assessed by eGFR; liver dysfunction by ALT, AST, or bilirubin levels.
  • Multivariable logistic regression adjusted for age, sex, and comorbidities.

Main Results:

  • 33.7% of 13,568 participants exhibited CVD-related polypharmacy.
  • Predictors included diabetes, chronic kidney disease, hypertension, and older age (≥80 years).
  • CVD polypharmacy was significantly associated with kidney dysfunction (OR 1.45), but not liver dysfunction (OR 1.19).

Conclusions:

  • CVD polypharmacy is common in patients on lipid-lowering therapy, associated with aging and multimorbidity.
  • The link with kidney dysfunction highlights the interplay between cardiovascular risk, physiological decline, and treatment burden.
  • Emphasizes the need for integrated, patient-centered prescribing for high-risk populations.
Abstract

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