Hyperlipidaemia accompanying hypertension spells higher healthcare cost for seniors

Older adults seeking care in the public primary care setting in Singapore often present with hyperlipidaemia and hypertension, a multimorbidity combination that drives up healthcare costs the most, as shown in a study.

In a large cohort of polyclinic patients aged ≥50 years, the top three conditions were hyperlipidaemia (72.9 percent), hypertension (64.6 percent), and diabetes (40.9 percent). Other conditions such as obesity, stroke, transient ischaemic attack (TIA), and gout had a prevalence of <10 percent. [J Multimorb Comorb 2026;doi:10.1177/26335565261417399]

The most prevalent and costly multimorbidity combinations comprised three to four conditions, with both hyperlipidaemia and hypertension co-occurring in these combinations, the authors noted.

Specifically, the combination of hyperlipidaemia/hypertension/diabetes was the most prevalent, at 8 percent. This was also associated with the highest total healthcare cost, at SGD 163,765,386.

In terms of total per capita costs across all care settings, hyperlipidaemia/hypertension/diabetes/kidney disease or failure ranked first, with per capita cost of SGD 7,293. This held true for per capita costs in the specialist outpatient centres (SGD 1,372), emergency department (SGD 188), and hospital (SGD 4,783).

Meanwhile, hyperlipidaemia/hypertension/diabetes/CVD was the combination with the highest per capita cost in the polyclinic (SGD 974).

“To the best of our knowledge, this is the first study that analysed all possible multimorbidity combinations within the public primary care setting in Singapore,” the authors said.

“By providing insights into the distribution and impact of multimorbidity in a real-world primary care context, our findings underscore the need for a more integrated, person-centred model of care,” they added.

Such a healthcare model is important, given that multimorbidity can exert a negative effect at the individual and macro levels, according to the authors.

They emphasized that older adults often struggle with a heavy treatment burden and a fragmented care system that is difficult to navigate—especially when facing social or functional decline. Furthermore, the increasing prevalence of multimorbidity within an ageing population can place a strain on healthcare budgets and workforce capacity, with long-term implications for population health and economic productivity, they explained.

For the study, the authors used administrative healthcare data from the Ministry of Health. A total of 502,036 patients (53.6 percent female, 79.5 percent Chinese) were included in the analysis. The patients had between one and 13 chronic conditions, with most having three co-occurring chronic conditions (23.9 percent).