Key result
Diabetes is linked to ~4.3-fold higher odds of resistant hypertension.
Why the study?
Resistant hypertension carries an increased risk of early target organ damage and cardiovascular and renal events, but data on its prevalence, patient characteristics, and associated factors in specialized outpatient settings were needed.
Cross-Sectional (n=104)
No
Odds Ratio: 4.28 (95% CI 1.41–12.97)
Absolute Event Rate: 63.6% vs 32.4%
p-value: p=0.010
The prevalence of resistant hypertension in a specialized Brazilian university clinic was 31.7%, which is higher than global estimates, potentially due to the high proportion of black and brown patients and the specialized setting.
BACKGROUND: Hypertension affects about 36 million Brazilians. It is estimated that 10%-20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events. OBJECTIVE: To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension. METHODS: Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil. RESULTS: A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD ± 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group. CONCLUSION: The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown ("pardos") patients in the population studied, and also because the study was performed in a specialized outpatient clinic.
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Moura et al. (2021) conducted a cross-sectional in Hypertension and resistant hypertension (n=104). Resistant hypertension vs. Non-resistant hypertension was evaluated on Prevalence of resistant hypertension and association with diabetes mellitus (OR 4.28, 95% CI 1.41-12.97, p=0.010). Resistant hypertension had a 31.7% prevalence in this specialized clinic and was significantly associated with diabetes (OR 4.28) and black or brown ethnicity (OR 3.35).
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