چکیده (انگلیسی):

Background:Hypertension is the most prevalent cardiovascular long-term condition in the UK and is associated
with a high rate of multimorbidity (MM). Multimorbidity increases with age, ethnicity and social deprivation.
Previous studies have yielded conflicting findings about the relationship between MM and blood pressure (BP)
control. Our aim was to investigate the relationship between multimorbidity and systolic blood pressure (SBP) in
patients with hypertension.
Methods:A cross-sectional analysis of anonymised primary care data was performed for a total of 299,180 adult
patients of whom 31,676 (10.6 %) had a diagnosis of hypertension. We compared mean SBP in patients with
hypertension alone and those with one or more co-morbidities and analysed the effect of type of comorbidity on
SBP. We constructed a regression model to identify the determinants of SBP control.
Results:The strongest predictor of mean SBP was the number of comorbidities,β−0.13 (p< 0.05). Other predictors
included Afro-Caribbean ethnicity, β0.05 (p< 0.05), South Asian ethnicity,β−0.03 (p< 0.05), age,β0.05 (p< 0.05),
male gender,β0.05 (p< 0.05) and number of hypotensive drugsβ0.06 (p< 0.05). SBP was lower by a mean of
2.03 mmHg (−2.22,−1.85) for each additional comorbidity and was lower in MM regardless of the type of
morbidity.
Conclusion:Hypertensive patients with MM had lower SBP than those with hypertension alone; the greater the
number of MM, the lower the SBP. We found no evidence that BP control was related to BP targets, medication
category or specific co-morbidity. Further research is needed to determine whether consultation rate,“white-coat
hypertension” or medication adherence influence BP control in MM.