The occurrence of drug-induced side effects in women and men with arterial hypertension and comorbidities

Abstract

Background:Women have been underrepresented in large clinical trials in hypertension, and the incidence of adverse drug reactions by sex has been not sufficiently described. Aims:The aim of the study was to determine the prevalence of adverse drug reactions in women and men with arterial hypertension and comorbidities and to assess the specific predisposing factors for adverse drug reactions by sex. Methods:The study population comprised consecutive hospitalized patients diagnosed with arterial hypertension and patients treated in an outpatient clinic, whose recruitment started in January 2019 aiming to reach 1000 participants. A structured questionnaire was used to gather the patients' demographic and clinical data and current or past cases of adverse drug reactions. Results:The study included 560 women and 440 men, with mean (standard deviation) age of 62.84 (14.96) years. Women were older than men, had a longer hypertension history, and suffered less frequently from other cardiovascular diseases. Women reported more frequently adverse drug reactions. The risk of drug-induced side effects in women increased with age (P = 0.03) and with coexistence of any respiratory disease (P = 0.04). In the case of male sex, the risk of adverse drug reactions increased with the occurrence of hypercholesterolemia (P = 0.03), and coexistence of any analyzed metabolic diseases (P = 0.04).Conclusions: Adverse drug reactions were reported more frequently by women. Older age and the presence of any respiratory disease increased the risk of adverse drug reactions in women, while in men, the risk was increased mainly by the presence of hypercholesterolemia or other metabolic diseases.

Sex differences in the occurrence and reporting of adverse drug reactions in hypertension: What are the clinical implications?

“…The data presented by Polaczyk et al [9] have several clinical implications. As mentioned by the authors, the first is the need to discuss regularly with patients and, in particular, with women how they tolerate their antihypertensive medications and how they feel about them to modify the drug prescription if necessary.…”

“…In the present issue of Kardiologia Polska (Kardiol Pol, Polish Heart Journal), Polaczyk et al [9] present the results of a recent survey performed among hypertensive patients hospitalized for arterial hypertension and patients treated in an outpatient clinic for their hypertension. The main objective of the survey was to assess the prevalence of adverse drug reactions in women and men with arterial hypertension and comorbidities and to assess the specific predisposing factors for adverse drug reactions by sex.…”

“…One of the possible reasons for the sex difference may be that women have less confidence in potential benefits of drugs and a different perception of health risks related to their hypertension. One important issue is that the reporting of adverse reactions or multiple drug intolerance, as observed in Polaczyk's study [9], is an important determinant of poor adherence and drug withdrawal. Indeed, the report of several side effects is often an indirect signal for patients to indicate that they are not willing to continue some of their medications.…”

“…Partial or complete non-adherence is a well-recognized factor associated with a worst control of blood pressure and increased risk of developing cardiovascular outcomes [15]. Unfortunately, Polaczyk et al [9] did not provide any information on blood pressure values in men and women reporting, or not, adverse drug reactions. This information would have been interesting in evaluating clinical impact of multiple drug intolerance or occurrence of adverse drug reactions.…”

The occurrence of drug-induced side effects in women and men with arterial hypertension and comorbidities

“…In this issue of Kardiologia Polska (Kardiol Pol, Polish Heart Journal), Polaczyk et al [9] present an elegant and detailed analysis of the frequency of ADRs in women and men with AH and comorbidities to assess the sex-specific predisposing factors leading to their occurrence. Based on 1000 consecutive patients (560 women and 440 men) diagnosed with AH, a 22-question structured questionnaire was used to gather demographic and clinical data.…”