Etiology in resistant hypertension

Aims: Resistant hypertension is defined as blood pressure that remains above goal despite the concurrent use of 3 antihypertensive agents of different classes. In resistant hypertensive patients, revealing the cause of secondary hypertension may allow drug or surgical treatment for the correction of hypertension. Resistant hypertensive patients, a significant portion of the hypertensive population, is estimated to occur. We aimed to investigate general characteristics and factors that make it difficult to control blood pressure in resistant hypertensive patients and to identify the incidence of secondary hypertension and secondary hypertension causes that play a role in the etiology of resistant hypertension. Methods: In the study, Turkish Republic Ministry of Health, İstanbul Medeniyet University Göztepe Training and Research Hospital Internal Medicine, Diabetes and Obesity clinic for any reason the applicant and resistant hypertension detected a total of 80 patients (32 men, 48 women, mean age: 62±10) were enrolled consecutively. The treatment characteristics of patients, as well as demographic, anthropometric, and biochemical data, were evaluated, and the cause of secondary hypertension and etiology distribution were determined. Results: In resistant hypertensive patients, the frequency of secondary hypertension was 60% (men 71%, women 52%). The most common causes of secondary hypertension are primary hyperaldosteronism (45%), obstructive sleep apnea syndrome (15%), and thyroid disorders (11%), respectively. 40% of the cases were diabetic, and 77.7% obese. Left ventricular hypertrophy and proteinuria were the most frequently detected target organ damage (96% and 37.5%, respectively). The average salt consumption of 10.75 grams/day was observed (males 12.2 g/day for females 9.7 g/day). There was analgesic use in 41% of cases, and in 3 cases, cola intake. Conclusion: Secondary hypertension was found to be 60% common. Compared to other studies in the literature, primary hyperaldosteronism and pheochromocytoma were more common causes of secondary hypertension, and the obstructive sleep apnea syndrome was lower than expected. Hypercortisolism is not detected, which can be considered a surprising finding.