Having 4 to 6 healthy lifestyle factors was associated with a lower risk of cardiovascular events compared to 0 to 1 factors in treatment-resistant hypertension (HR 0.63; 95% CI 0.41-0.95).
Cohort (n=2,043)
Yes
Do healthy lifestyle factors reduce cardiovascular events and mortality in individuals with apparent treatment-resistant hypertension?
Adherence to healthy lifestyle factors, particularly physical activity and nonsmoking, is associated with a significantly lower risk of cardiovascular events and mortality in patients with treatment-resistant hypertension.
Hazard Ratio: 0.63 (95% CI 0.41–0.95)
p-value: p=0.020
Few data exist on whether healthy lifestyle factors are associated with better prognosis among individuals with apparent treatment-resistant hypertension, a high-risk phenotype of hypertension. The purpose of this study was to assess the association of healthy lifestyle factors with cardiovascular events, all-cause mortality, and cardiovascular mortality among individuals with apparent treatment-resistant hypertension. We studied participants (n=2043) from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) study with apparent treatment-resistant hypertension (blood pressure ≥140/90 mm Hg despite the use of 3 antihypertensive medication classes or the use of ≥4 classes of antihypertensive medication regardless of blood pressure control). Six healthy lifestyle factors adapted from guidelines for the management of hypertension (normal waist circumference, physical activity ≥4 times/week, nonsmoking, moderate alcohol consumption, high Dietary Approaches to Stop Hypertension diet score, and low sodium-to-potassium intake ratio) were examined. A greater number of healthy lifestyle factors were associated with lower risk for cardiovascular events (n=360) during a mean follow-up of 4.5 years. Multivariable-adjusted hazard ratios HR (95% confidence interval) for cardiovascular events comparing individuals with 2, 3, and 4 to 6 versus 0 to 1 healthy lifestyle factors were 0.91 (0.68-1.21), 0.80 (0.57-1.14), and 0.63 (0.41-0.95), respectively (P-trend=0.020). Physical activity and nonsmoking were individual healthy lifestyle factors significantly associated with lower risk for cardiovascular events. Similar associations were observed between healthy lifestyle factors and risk for all-cause and cardiovascular mortality. In conclusion, healthy lifestyle factors, particularly physical activity and nonsmoking, are associated with a lower risk for cardiovascular events and mortality among individuals with apparent treatment-resistant hypertension.
Diaz et al. (Tue,) conducted a cohort in Apparent treatment-resistant hypertension (n=2,043). 4 to 6 healthy lifestyle factors vs. 0 to 1 healthy lifestyle factors was evaluated on Cardiovascular events (HR 0.63, 95% CI 0.41-0.95, p=0.020). Having 4 to 6 healthy lifestyle factors was associated with a lower risk of cardiovascular events compared to 0 to 1 factors in treatment-resistant hypertension (HR 0.63; 95% CI 0.41-0.95).
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