Key result
Uncontrolled resistant hypertension was significantly associated with increased short-term systolic blood pressure variability (average real variability 14.52 vs 12.66, p=0.013) and older age.
Observational (n=114)
No
Absolute Event Rate: 14.52% vs 12.66%
p-value: p=0.013
In patients with resistant hypertension, older age and increased short-term blood pressure variability are associated with uncontrolled ambulatory blood pressure.
Requires prospective validation before guiding resistant hypertension care; hypothesis-generating for BP variability as prognostic marker.
BACKGROUND: Uncontrolled resistant hypertension (RH) defined by the mean 24-hour ambulatory blood pressure (ABPM) represents an independent risk factor in hypertensive patients. Predictors of blood pressure (BP) control in RH are not yet clearly defined. OBJECTIVES: To evaluate the predictors of BP control in RH patients with repeated ABPM measurements. METHODS: 114 consecutive patients from outpatient cardiology office fulfilling criteria for RH (office BP ≥ 140 and/or 90 mmHg, with treatment of ≥ 3 antihypertensive drugs, including diuretic, or controlled BP with > 3 drugs), with two consecutive ABPM studies were compared in clinical characteristics according to BP control assessed by ABPM RESULTS: After the second ABPM, BP was controlled in 25.4 % of patients; the remaining 74.6 % were classified as uncontrolled. In the uncontrolled BP group, systolic office BP was 140.91±16.71 mmHg, diastolic 81.26 ± 10.92 mmHg. In ABPM, systolic was 145.11 ± 13.65 mmHg, diastolic 81.26 ± 10.92 mmHg. Compared to the controlled BP group, in the uncontrolled group the age was higher 72.32 ±10.89 years (p = 0.047), baseline average real variability of systolic BP was lower 12.66 ± 3.08 vs. 14.52 ± 3.53 (p = 0.013), no significant difference in baseline standard deviation of systolic BP changes was found. CONCLUSION: Higher office BP, older age, and increased short term BP variability were associated with an uncontrolled hypertension. Stronger association was found with baseline average real variability rather than standard deviation. No significant differences were found in the dipping status and other clinical characteristics (Tab. 6, Fig. 1, Ref. 28).
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Páleš et al. (2016) conducted an observational in Resistant hypertension (n=114). Uncontrolled resistant hypertension vs. Controlled resistant hypertension was evaluated on Baseline average real variability of systolic blood pressure (p=0.013). Uncontrolled resistant hypertension was significantly associated with increased short-term systolic blood pressure variability (average real variability 14.52 vs 12.66, p=0.013) and older age.
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