The impact of body mass index and number of antihypertensive medications on clinical management of hypertension in primary health care

Abstract

Introduction: Hypertension (HTN) is an extremely common disease and its prevalence is increasing globally. The association between obesity and HTN is not yet fully understood, insulin resistance and renal dysfunction are said to be the main causes of obesity-related HTN. This study explored the effect of obesity and different number of medications on blood pressure (BP) control in patients with HTN. Methods: This was a retrospective study conducted in the outpatient primary care clinic at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Results: A total of 286 patients were included in the study with an average weight of 80.6 kg and an average body mass index (BMI) of 32.2. Only 63% of the participants had controlled BP. There was a trend toward better controlled BP levels among male participants (67.1%) compared with females (57.7%) and among those with higher BMI levels, P = 0.099 and 0.094, respectively. Patients receiving two antihypertensive medications were more likely to have their BP controlled compared to those receiving four medications (odds ratio [95% confidence interval] =2.62 [1.32, 5.20]; P = 0.006). Conclusion: Uncontrolled BP was not associated with BMI. Taking two antihypertensive medications was associated with more BP control than monotherapy or combination of therapy with three drugs or more.

Keywords

• body mass index
• hypertension
• obesity
• polypharmacy
• primary health care