Incidence and Prognosis of Resistant Hypertension in Hypertensive Patients
By S. Daugherty, J. Powers, David J. Magid, Heather M. Tavel, Frederick A. Masoudi, Karen L. Margolis, Patrick J. O’Connor, J. Selby, P. M. Ho. Circulation, 2012
689 citations recorded by the source corpus.
Background— Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension, the incidence and prognosis of this condition are largely unknown. Methods and Results— This retrospective cohort study in 2 integrated health plans included patients with incident hypertension in whom treatment was begun between 2002 and 2006. Patients were followed up for the development of resistant hypertension based on AHA criteria of uncontrolled blood pressure despite use of ≥3 antihypertensive medications, with data collected on prescription filling information and blood pressure measurement. We determined incident cardiovascular events (death or incident myocardial infarction, heart failure, stroke, or chronic kidney disease) in patients with and without resistant hypertension with adjustment for patient and clinical characteristics. Among 205 750 patients with incident hypertension, 1.9% developed resistant hypertension within a median of 1.5 years from initial treatment (0.7 cases per 100 person-years of follow-up). These patients were more often men, were older, and had higher rates of diabetes mellitus than nonresistant patients. Over 3.8 years of median follow-up, cardiovascular event rates were significantly higher in those with resistant hypertension (unadjusted 18.0% versus 13.5%, P<0.001). After adjustment for patient and clinical characteristics, resistant hypertension was associated with a higher risk of cardiovascular events (hazard ratio, 1.47; 95% confidence interval, 1.33–1.62). Conclusions— Among patients with incident hypertension in whom treatment was begun, 1 in 50 patients developed resistant hypertension. Patients with resistant hypertension had an increased risk of cardiovascular events, which supports the need for greater efforts toward improving hypertension outcomes in this population.
Subfields: Cardiology and Cardiovascular Medicine, Nutrition and Dietetics
View Paper: https://www.semanticscholar.org/paper/b84b7bd3b60f895913d3626c82a281864fc2e0c9
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In Cardiology and Cardiovascular Medicine
In Nutrition and Dietetics
Citations in the corpus
- The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. (2013, background): “Resistant hypertension is associated with a high risk of CV and renal events [597–600].”
- 2016 European Guidelines on cardiovascular disease prevention in clinical practice (2016, background): “Resistant hypertension is associated with a high risk of CV and renal events.(453) Before a patient is considered treatment resistant, consideration should be given to a lack of treatment adherence, white coat syndrome or high salt or alcohol intake, as well as drug intake with a potential pressor e”
- Resistant Hypertension: Detection, Evaluation, and Management (2018, background): “events in this study were driven largely by a higher risk for the development of CKD.(23) In another study of >400 000 patients,”
- 2016 European Guidelines on cardiovascular disease prevention in clinical practice. (2016, background): “Resistant hypertension is associated with a high risk of CV and renal events.(453) Before a patient is considered treatment resistant, consideration should be given to a lack of treatment adherence, white coat syndrome or high salt or alcohol intake, as well as drug intake with a potential pressor e”