Key result
Female hypertensive patients show higher multimorbidity and ~149% greater stroke incidence vs males.
Why the study?
Hypertension management is increasingly challenged by multimorbidity, requiring evaluation of how accumulating conditions affect cardiac remodeling, systolic function, and cerebrovascular risk across genders.
Cross-Sectional (n=214)
Absolute Event Rate: 3.52% vs 3.03%
p-value: p=0.045
In hypertensive patients, multimorbidity is highly prevalent and associated with worse cardiac performance (lower LVEF), with women experiencing a higher disease burden and stroke risk than men.
May support enhanced multimorbidity screening in female hypertensives; leaves open causal stroke links and need for prospective studies.
Objective: Hypertension management is increasingly challenged by the presence of multimorbidity. This study evaluates the clinical complexity of hypertensive patients, investigating how the accumulation of associated conditions influences cardiac structural remodeling, systolic function, and the risk of major cerebrovascular events, with a specific focus on gender-related disparities. Design and method: A cross-sectional study was conducted on 214 hypertensive patients (mean age 65.2 ± 11.5 years, 73.8% female). We assessed the major chronic conditions to quantify the multimorbidity burden. Target organ damage (TOD) was evaluated through echocardiographic parameters - interventricular septum thickness (IVS) and left ventricular ejection fraction (LVEF) - and history of stroke. Statistical analysis included Pearson correlations, t-tests, and linear regression models. Results: The study revealed a high burden of multimorbidity, with a mean of 3.4 ± 1.2 conditions per patient. The most prevalent risk cluster was the chronic ischemic heart disease – Heart Failure - Dyslipidemia (CIHD–HF–dyslipidemia) triad (76.1%, 67.7%, and 59.3%, respectively). Significant gender disparities were observed: women exhibited a significantly higher multimorbidity burden compared to men (3.52 vs. 3.03 conditions, p = 0.045). Consequently, the incidence of stroke was more than 2-fold higher in the female cohort (4.43% vs. 1.78%). Regarding TOD, systolic blood pressure (SBP) was a significant predictor of IVS hypertrophy (p = 0.015). Furthermore, a strong negative correlation was identified between the number of comorbidities and LVEF (r = -0.45, p < 0.001), indicating that each additional pathology significantly impairs cardiac performance. Age was also directly associated with the accumulation of comorbidities (p < 0.001). Conclusions: Multimorbidity is the clinical norm in hypertensive populations, not the exception. Our findings highlight a disproportionate disease burden and increased stroke risk in females, who also show more advanced cardiac remodeling. These results emphasize the necessity for sex-specific, integrated management strategies in elderly hypertensive patients to mitigate the synergistic impact of comorbidities on target organ deterioration.
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Grigoroaea et al. (2026) conducted a cross-sectional in Arterial hypertension (n=214). Female gender vs. Male gender was evaluated on Multimorbidity burden (number of conditions) (p=0.045). Female hypertensive patients exhibited a significantly higher multimorbidity burden than males (3.52 vs. 3.03 conditions, p=0.045) and a higher incidence of stroke (4.43% vs. 1.78%).
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