Key result
Hypertension control provided less protection against cardiovascular disease in patients with apparent treatment-resistant hypertension than those without.
Why the study?
Does hypertension control provide less cardiovascular protection in adults with apparent treatment-resistant hypertension compared to those without?
Cohort (n=118,356)
Does hypertension control provide less cardiovascular protection in adults with apparent treatment-resistant hypertension compared to those without?
Blood pressure control provides significantly less protection against incident cardiovascular events in patients with apparent treatment-resistant hypertension compared to those without, suggesting additional risk-reduction strategies are needed.
Answers are grounded in this paper and cite their sources.
BP control may confer less CVD protection in aTRH; hypothesis-generating for aTRH-specific strategies.
Hypertension control may offer less protection from incident cardiovascular disease (CVDi ) in adults with than without apparent treatment-resistant hypertension (aTRH), ie, blood pressure uncontrolled while taking three or more antihypertensive medications or controlled to <140/<90 mm Hg while taking four or more antihypertensive medications. Electronic health data were matched to health claims for 2006-2012. Patients with CVDi in 2006-2007 or with untreated hypertension were excluded, leaving 118,356 treated hypertensives, including 40,690 with aTRH, and 460,599 observation years. Blood pressure and medication number were determined by all clinic visit means from 2008 to CVDi or end of study. Primary outcome was first CVDi (stroke, coronary heart disease, heart failure) from hospital and emergency department claims. Controlling for age, race, sex, diabetes, chronic kidney disease, and statin use, hypertension control afforded less CVDi protection in patients with aTRH (hazard ratio, 0.87; 95% confidence interval, 0.82-0.93) than without aTRH (hazard ratio, 0.69; 95% confidence interval, 0.65-0.74; P<.001). Strategies beyond hypertension control may prevent more CVDi in patients with aTRH.
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Egan et al. (2016) conducted a cohort in Hypertension (n=118,356). Hypertension control vs. Uncontrolled hypertension was evaluated on First incident cardiovascular disease (stroke, coronary heart disease, heart failure) (HR 0.87, 95% CI 0.82-0.93, p=<.001). Hypertension control provided less protection against cardiovascular disease in patients with apparent treatment-resistant hypertension than those without.
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