<![CDATA[Hypertension management in patients with comorbidities requires drug selection and dosing that are consistent with clinical conditions, organ function, and evidence-based recommendations. Inappropriate therapy may compromise blood pressure control and increase treatment-related risk. To evaluate the rationality of antihypertensive therapy and its association with blood pressure control among hospitalised patients with hypertension and comorbidities. An analytical retrospective cohort study used medical records from January to August 2025 at a public hospital in Central Java, Indonesia. Total sampling identified 76 eligible patients. Rational therapy required concordant assessments of right patient, right drug, and right dose. Blood pressure control was defined as a final measurement below 140/90 mmHg. Descriptive statistics, the Wilcoxon signed-rank test, and Fisher’s exact test were used. The mean age was 59.37 ± 13.01 years and 51.3% were male. Overall therapy was rational in 68 patients (89.5%); right-patient and right-dose criteria were each fulfilled in 98.7%, while right-drug criteria were fulfilled in 89.5%. Mean blood pressure declined from 187.39/100.24 mmHg to 133.07/81.89 mmHg (p<0.001). Forty-seven patients (61.8%) achieved control. Control occurred in 63.2% of the rational group and 50.0% of the non-rational group; the association was not statistically significant (OR 1.72; 95% CI 0.40–7.49; p=0.472). Most antihypertensive regimens met the documented rationality criteria and blood pressure improved substantially during hospitalisation. Although control was more frequent with rational therapy, the association was inconclusive because the non-rational group was small and inpatient outcomes were influenced by multiple clinical factors.]]>
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