MULTIPLE DRUG INTOLERANCE IN PATIENTS WITH ARTERIAL HYPERTENSION: PREVALENCE AND DETERMINING FACTORS

Abstract

Objective: One of the reasons for patients’ poor medication compliance is the occurrence of drug-induced adverse events. The aim of this study was to determine the prevalence of Multiple Drug Intolerance Syndrome (MDIS), defined as adverse events after 3 or more drug classes, in a group of patients with arterial hypertension and to assess the predisposing factors. Design and method: The study population comprised hospitalized patients diagnosed with arterial hypertension as well as patients undergoing chronic treatment in an outpatient hypertension clinic. A structured proprietary questionnaire was used, which focused on demographic and clinical data, including current or past incidences of adverse drug reactions. Results: The study population comprised a total of 1000 patients, including 560 women. The mean age was 62.84 ± 14.96 years. Eighty patients (8%) suffered from MDIS. A significantly higher percentage of patients with MDIS were women (71% vs. 55%, p = 0.006) and patients with longer-lasting hypertension (median 15 vs. 10 years, p = 0.008). Moreover, among patients with MDIS, the following disorders were more frequent: respiratory (21% vs. 11%, p = 0.013), gastrointestinal (25% vs. 13%, p = 0.003), rheumatic (24% vs. 9%, p < 0.001) and endocrine (29% vs. 16%, p = 0.007). The risk of MDIS was highest in the case of concomitant use of analgesics, OR = 65.59, p < 0.001, followed by beta-blockers, OR = 48.42, p < 0.001, antiplatelet drugs, OR = 47.26, p < 0.001 and antibiotics OR = 30.04, p < 0.001. Conclusions: MDIS in patients with hypertension is common and affects more frequently women and patients with a longer disease duration. Comorbidities increase risk of MDIS. The risk of MDIS is most strongly associated with the use of analgesics, beta-blockers, antiplatelet drugs and antibiotics.