Association between polypharmacy and hypertension in the Iranian population aged 50 years or older: Iranian Multicenter Osteoporosis Study (IMOS-2021)

Hypertension is a major global health concern associated with chronic conditions, particularly in aged adults. Managing these conditions often requires multiple medications, raising the risk of polypharmacy. This study evaluates the association between polypharmacy and blood pressure (BP) status among hypertensives versus normotensives, also analyzing demographic and comorbidity factors. This cross-sectional population-based study examined data from the national Iranian Multicenter Osteoporosis Study (IMOS-2021), which utilized a multi-stage random sampling to gather data of aged ≥ 50 years. Polypharmacy and hypertension (HTN) were defined as the use of ≥ 3 or ≥ 5 medications, and systolic BP (SBP) ≥ 140 and diastolic BP (DBP) ≥ 90 mmHg, respectively. Multiple logistic regression models were used to assess the association. Fully adjusted model was including age, sex, waist circumference, residencial area, employment, education, alcohol consumption, and smoking. This study of 1,368 Iranians found a higher association between polypharmacy and HTN versus normotension (≥ 3 drugs: 43.03% vs. 17.93% ; ≥5 drugs: 19.95% vs. 6.01%). This association was more prevalent among older adults, females, rural residents, and those with ≥ 2 comorbidities. Uncontrolled HTN was significantly linked to increased medication use (adjusted Odds Ratio 1.15 per added drug). Due to the significant association between polypharmacy and HTN, especially uncontrolled HTN, in older adults, physicians should be aware of the potential adverse effect of unnecessary prescriptions on the health of aged HTN patients.