Key result
Among 12,375 treated hypertensive patients, resistant hypertension was present in 24.7% and independently associated with male sex, diabetes, cardiovascular disease, and impaired renal function.
Observational (n=12,375)
Yes
In a large Polish cohort, nearly a quarter of treated hypertensive patients had resistant hypertension, which was strongly associated with multiple cardiovascular and metabolic comorbidities as well as underuse of preferred drug combinations.
Identifies RHT correlates in Polish primary care; leaves open causality and need for prospective validation.
INTRODUCTION: Patients with resistant hypertension (RHT) are at high risk for coronary artery disease (CAD) and cerebrovascular disease (CVD), compared with the general hypertensive population. OBJECTIVES: The aim of the study was to evaluate factors associated with RHT in a large sample of hypertensive patients under the care of general practitioners and specialists in Poland. PATIENTS AND METHODS: We included 12 375 patients (mean age, 64.0 ±12.3 years; age range, 18-98 years; women, 59%) with hypertension treated for at least 1 year. Patients were divided into 3 groups: with controlled hypertension, uncontrolled hypertension (not fulfilling the criteria for RHT), and RHT. RESULTS: Controlled hypertension, uncontrolled hypertension, and RHT were found in 47.3%, 27.9%, and 24.7% of the patients, respectively. The RHT rate was higher in patients visiting specialist offices (29.8%) and in patients with diabetes (32.5%), CAD (31.5%), CVD (33.3%), and impaired renal function (31.9%). Patients with RHT were characterized by the highest rate of high (23.5%) and very high (60.5%) added cardiovascular risk. An underuse of preferred antihypertensive drug combinations and aldosterone antagonists in patients with uncontrolled hypertension and RHT was observed. In a multivariate analysis, RHT was independently associated with male sex, higher pulse pressure, metabolic syndrome, diabetes, CAD, CVD, diseases requiring treatment with nonsteroidal anti-inflammatory drugs and an estimated glomerular filtration rate of less than 60 ml/min/1.73 m2. CONCLUSIONS: The vast majority of patients with RHT carry a high or very high cardiovascular risk. In addition, the underuse of preferred antihypertensive drug combinations and aldosterone antagonists has been observed.
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Prejbisz et al. (2015) conducted an observational in Hypertension (n=12,375). Risk factors for resistant hypertension vs. Absence of risk factors was evaluated on Resistant hypertension (RHT). Among 12,375 treated hypertensive patients, resistant hypertension was present in 24.7% and independently associated with male sex, diabetes, cardiovascular disease, and impaired renal function.
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