Effectiveness of Antihypertensive Monotherapy and Combination Therapy in Managing Blood Pressure Among the Elderly

OBJECTIVE To evaluate the effectiveness of monotherapy versus combination therapy in controlling blood pressure in the elderly population in eastern Indonesia, i.e., Central Sulawesi. METHODS This study used a cross-sectional design, examining secondary data from the medical records of inpatients with hypertension in a population in eastern Indonesia. The inclusion criteria included patients aged 45 years or older receiving antihypertensive therapy who had complete blood pressure data. Data were analyzed using R 4.3.2. Relationships between variables were tested using inferential analysis. A p-value < 0.05 was set as the statistical significance threshold. RESULTS Most patients were female (60.0%) and aged 45-59 years (40.0%). Nearly half (48.0%) had been diagnosed with uncomplicated hypertension, while 29.0% also had cardiovascular comorbidities. Patients received either monotherapy or combination therapy, with calcium channel blockers (CCBs) being the most common drug class used. Blood pressure significantly decreased after therapy, with mean systolic pressure reduced from 162 to 135 mmHg and diastolic from 95 to 79 mmHg (p = 0.000). Combination therapy produced a slightly greater reduction than monotherapy, although the difference was not statistically significant. These findings suggest that both monotherapy and combination therapy can effectively reduce blood pressure in elderly patients, with combination therapy offering potential advantages. This study highlights the need for personalized treatment strategies that consider the age, comorbidities, and drug tolerance of all elderly patients based on hypertension therapy guidelines. CONCLUSION Both combination and monotherapy treatment strategies are similarly effective in lowering blood pressure in elderly patients. Given the presence of comorbidities and the risk of side effects, a personalized approach using combination therapy may offer an effective and safe option for managing hypertension in geriatric patients. These findings support more informed and tailored clinical decision-making in hospital care settings.