Cardiovascular disease (CVD) remains the leading cause of death globally and affects a substantial proportion of patients seen in wound care settings.

According to the American Heart Association, nearly half of U.S. adults live with some form of cardiovascular disease.⁴ Hypertension alone affects nearly half of American adults, while millions more live with coronary artery disease, heart failure, peripheral artery disease, atrial fibrillation, or cerebrovascular disease.

These conditions often require multiple long-term therapies. Antihypertensives, lipid-lowering agents, antiplatelet medications, anticoagulants, diuretics, and antiarrhythmic therapies are among the most commonly prescribed medications in older adults.⁵

The overlap between cardiovascular disease and wound care is substantial. Patients with arterial disease, venous disease, diabetes, and chronic edema frequently require coordinated management involving multiple specialties. As a result, medication regimens often become increasingly complex over time.

The growing prevalence of cardiovascular disease means that wound care clinicians are likely to encounter patients taking numerous medications, even before therapies directly related to wound management are considered.

Polypharmacy Has Become the New Normal

Polypharmacy is commonly defined as the concurrent use of five or more medications. While often discussed as a geriatric care issue, it has increasingly become a defining characteristic of medically complex populations.⁶

Recent U.S. data demonstrate the magnitude of this trend. Analysis published in JAMA Internal Medicine found that approximately 43% of adults aged 65 years and older reported using 5 or more prescription medications between 2017 and 2020. Hyperpolypharmacy—commonly defined as the use of 10 or more medications—also increased substantially over the past 2 decades.⁵

The rise in polypharmacy reflects broader changes in healthcare. Advances in medicine have improved survival for conditions that were once rapidly fatal. However, longer survival frequently means longer-term management of multiple chronic diseases.

A large systematic review examining multimorbidity and polypharmacy found that the coexistence of multiple chronic conditions and multiple medications has become increasingly common worldwide.⁶ Researchers described both trends as major healthcare challenges requiring greater attention from clinicians, health systems, and policymakers.

For wound care professionals, polypharmacy is not merely a prescribing issue—it represents a reflection of patient complexity. Every additional medication may represent another disease state, another specialist, another clinical priority, and another factor influencing overall patient care.

The Economic Impact of Medication Complexity

The consequences of multimorbidity and polypharmacy extend beyond clinical complexity.

Patients with multiple chronic diseases account for a disproportionate share of healthcare expenditures, hospitalizations, and healthcare utilization. Studies consistently demonstrate that individuals with multimorbidity are among the highest users of healthcare resources.⁷

Polypharmacy has likewise been associated with increased healthcare costs, greater monitoring requirements, and higher rates of hospitalization.⁸ As healthcare systems increasingly focus on outcomes, resource utilization, and value-based care, understanding the role of medication burden becomes increasingly important.

The economic implications are particularly relevant in wound care, where chronic wounds already contribute billions of dollars in annual healthcare expenditures. The convergence of chronic wounds, chronic disease, and polypharmacy creates a patient population with significant clinical and financial complexity.

Looking Ahead

The intersection of aging, diabetes, cardiovascular disease, and polypharmacy is reshaping the wound care landscape. As the prevalence of chronic disease continues to rise, wound care professionals are increasingly likely to encounter patients whose medication profiles reflect extensive medical complexity.

Understanding these trends is an important first step toward appreciating the broader pharmacologic challenges that accompany modern wound care practice. The question facing clinicians is no longer whether medication complexity exists—it is how prepared healthcare professionals are to recognize its potential impact on patient care.