Document Detail


Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring.
MedLine Citation:
PMID:  21444835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to estimate the prevalence of resistant hypertension through both office and ambulatory blood pressure monitoring in a large cohort of treated hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. In addition, we also compared clinical features of patients with true or white-coat-resistant hypertension. In December 2009, we identified 68 045 treated patients with complete information for this analysis. Among them, 8295 (12.2% of the database) had resistant hypertension (office blood pressure ≥140 and/or 90 mm Hg while being treated with ≥3 antihypertensive drugs, 1 of them being a diuretic). After ambulatory blood pressure monitoring, 62.5% of patients were classified as true resistant hypertensives, the remaining 37.5% having white-coat resistance. The former group was younger, more frequently men, with a longer duration of hypertension and a worse cardiovascular risk profile. The group included larger proportions of smokers, diabetics, target organ damage (including left ventricular hypertrophy, impaired renal function, and microalbuminuria), and documented cardiovascular disease. Moreover, true resistant hypertensives exhibited in a greater proportion a riser pattern (22% versus 18%; P<0.001). In conclusion, this study first reports the prevalence of resistant hypertension in a large cohort of patients in usual daily practice. Resistant hypertension is present in 12% of the treated hypertensive population, but among them more than one third have normal ambulatory blood pressure. A worse risk profile is associated with true resistant hypertension, but this association is weak, thus making it necessary to assess ambulatory blood pressure monitoring for a correct diagnosis and management.
Authors:
Alejandro de la Sierra; Julián Segura; José R Banegas; Manuel Gorostidi; Juan J de la Cruz; Pedro Armario; Anna Oliveras; Luis M Ruilope
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-03-28
Journal Detail:
Title:  Hypertension     Volume:  57     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-21     Completed Date:  2011-06-30     Revised Date:  2011-10-21    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  898-902     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Plaza Dr Robert 5, 08221-Terrassa, Spain. adelasierra@mutuaterrassa.es
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Antihypertensive Agents / therapeutic use
Blood Pressure
Blood Pressure Monitoring, Ambulatory*
Chi-Square Distribution
Female
Humans
Hypertension / classification,  diagnosis*,  epidemiology*,  etiology
Male
Middle Aged
Prevalence
Registries
Risk
Sex Factors
Smoking / adverse effects
Spain / epidemiology
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
Hypertension. 2011 Oct;58(4):e28   [PMID:  21825232 ]
Hypertension. 2011 May;57(5):889-90   [PMID:  21444834 ]
Hypertension. 2011 Aug;58(2):e5; author reply e6   [PMID:  21670417 ]
Hypertension. 2011 Oct;58(4):e23; author reply e24-5   [PMID:  21825223 ]
Hypertension. 2011 Oct;58(4):e26; author reply e27   [PMID:  21825226 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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