Document Detail

Evaluation and treatment of resistant or difficult-to-control hypertension.
MedLine Citation:
PMID:  19128272     Owner:  NLM     Status:  MEDLINE    
An observational study was conducted in 164 patients with resistant or difficult-to-control hypertension. Treatment was adjusted to achieve blood pressure recommendations from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Patients were mostly male (95.73%) and African American (86.59%) and had an average age of 63.68 years. Comorbidities included diabetes (42.07%) and chronic kidney disease, with an average estimated glomerular filtration rate of 83.55 mL/min/1.73 m(2). At the time of referral, average blood pressure was 160/87 mm Hg. The average number of antihypertensive medications per patient at baseline was 3.43, which increased to 4.06 and 4.18 at 3 and 6 months, respectively (P< or =.0008), with about 80% of patients receiving a diuretic prior to intervention. Blood pressure decreased to 135.55/74.55 and 137.62/74.03 mm Hg at 3 and 6 months, respectively (P<.0001). By month 6, the blood pressure goal was reached in 45.10% of patients. At months 3 and 6, 100% of patients were now receiving a diuretic. The average estimated glomerular filtration rate at month 6 was 79.36 mL/min/1.73 m(2) (P=NS). Patients referred for resistant or difficult-to-control hypertension may be controlled by making targeted adjustments to their medical regimen.
David Wojciechowski; Vasilios Papademetriou; Charles Faselis; Ross Fletcher
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  10     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2009-01-08     Completed Date:  2009-02-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  837-43     Citation Subset:  IM    
Department of Veterans Affairs and Georgetown University Hospital, Washington, DC 20422, USA.
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MeSH Terms
African Americans / statistics & numerical data
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects*
Diastole / drug effects
District of Columbia / epidemiology
Drug Resistance
Glomerular Filtration Rate
Hypertension / drug therapy*,  ethnology,  physiopathology
Life Style
Middle Aged
Systole / drug effects
United States / epidemiology
Reg. No./Substance:
0/Antihypertensive Agents

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

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