ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2026
Multimorbidity and cardiovascular prevention in primary care: a cohort study in New Zealand.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMultimorbidity adds complexity to cardiovascular disease (CVD) prevention. Clinical guidelines in Aotearoa New Zealand recommend combined blood pressure- and lipid-lowering therapy ('dual therapy') for most people at high (≥15%) 5-year CVD risk; recommend shared decision making for those at intermediate risk (5-14%); and do not generally recommend dual therapy for those at low risk (<5%).
aimTo examine the association between multimorbidity and dispensing of dual therapy across CVD risk groups. DESIGN AND
settingCohort study of patients enrolled in a primary health organisation serving the Auckland region of northern New Zealand.
methodThe study included 430 286 adults aged 30-79 years without prior CVD who were enrolled in ProCare in 2014. Multivariable Poisson regression was used to estimate relative risks (RRs) for receiving dual therapy within each CVD risk group. Two-year maintenance of dual therapy was compared by multimorbidity status.
resultsBaseline dual therapy dispensing was 2.5%, 31%, and 40% in the low-, intermediate-, and high-risk groups, respectively. Multimorbidity was associated with a greater likelihood of receiving dual therapy across all risk groups (low risk: RR 2.90, 95% confidence interval (CI) = 2.77 to 3.03; intermediate risk: RR 1.35, 95% CI = 1.32 to 1.38; high risk: RR 1.15, 95% CI = 1.10 to 1.22). Among participants receiving dual therapy at baseline, maintenance was higher among those with multimorbidity in the low-risk group (88% versus 84%) and intermediate-risk group (90% versus 86%) (both
conclusionPatients with multimorbidity were more likely to receive and maintain guideline-recommended CVD preventive therapy than those without multimorbidity. However, despite increasing use of dual therapy with increasing CVD risk, substantial evidence-practice gaps remained among patients at high CVD risk.
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