Prevalence and clinical characteristics of refractory hypertension

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• dc.contributor.author Armario, Pedro
• dc.contributor.author Calhoun, David A.
• dc.contributor.author Oliveras, Anna
• dc.contributor.author Blanch, Pedro
• dc.contributor.author Vinyoles, Ernest
• dc.contributor.author Banegas, Jose R.
• dc.contributor.author Gorostidi, Manuel
• dc.contributor.author Segura, Julián
• dc.contributor.author Ruilope, Luis Miguel
• dc.contributor.author Dudenbostel,Tanja
• dc.contributor.author Sierra, Alejandro de la
• dc.date.accessioned 2018-11-28T08:39:54Z
• dc.date.available 2018-11-28T08:39:54Z
• dc.date.issued 2017
• dc.description.abstract BACKGROUND: We aimed to estimate the prevalence of refractory hypertension (RfH) and to determine the clinical differences between these patients and resistant hypertensives (RH). Secondly, we assessed the prevalence of white-coat RfH and clinical differences between true- and white-coat RfH patients. METHODS AND RESULTS: The present analysis was conducted on the Spanish Ambulatory Blood Pressure Monitoring Registry database containing 70 997 treated hypertensive patients. RH and RfH were defined by the presence of elevated office blood pressure (≥140 and/or 90 mm Hg) in patients treated with at least 3 (RH) and 5 (RfH) antihypertensive drugs. White-coat RfH was defined by RfH with normal (<130/80 mm Hg) 24-hour blood pressure. A total of 11.972 (16.9%) patients fulfilled the standard criteria of RH, and 955 (1.4%) were considered as having RfH. Compared with RH patients, those with RfH were younger, more frequently male, and after adjusting for age and sex, had increased prevalence of target organ damage, and previous cardiovascular disease. The prevalence of white coat RfH was lower than white-coat RH (26.7% versus 37.1%, P<0.001). White-coat RfH, in comparison with those with true RfH, showed a lower prevalence of both left ventricular hypertrophy (22% versus 29.7%; P=0.018) and microalbuminuria (28.3% versus 42.9%; P=0.047). CONCLUSIONS: The prevalence of RfH was low and these patients had a greater cardiovascular risk profile compared with RH. One out of 4 patients with RfH have normal 24-hour blood pressure and less target organ damage, thus indicating the important role of ambulatory blood pressure monitoring in guiding antihypertensive therapy in difficult-to-treat patients.
• dc.format.mimetype application/pdf
• dc.identifier.citation Armario P, Calhoun DA, Oliveras A, Blanch P, Vinyoles E, Banegas JR. Et al. Prevalence and clinical characteristics of refractory hypertension. J Am Heart Assoc. 2017 Dec 7;6(12). 1-7: e007365. DOI: 10.1161/JAHA.117.007365
• dc.identifier.doi http://dx.doi.org/10.1161/JAHA.117.007365
• dc.identifier.issn 2047-9980
• dc.identifier.uri http://hdl.handle.net/10230/35869
• dc.language.iso eng
• dc.publisher Wiley
• dc.relation.ispartof Journal of the American Heart Association. 2017 Dec 7;6(12):e007365
• dc.rights Copyright © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the https://creativecommons.org/licenses/by-nc-nd/4.0/, Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Refractory hypertension
• dc.subject.keyword Resistant hypertension
• dc.subject.keyword Target organ damage
• dc.subject.keyword White coat refractory hypertension
• dc.subject.other Hipertensió
• dc.title Prevalence and clinical characteristics of refractory hypertension
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion