Document Detail


Incidence and prognosis of resistant hypertension in hypertensive patients.
MedLine Citation:
PMID:  22379110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension, the incidence and prognosis of this condition are largely unknown.
METHODS AND RESULTS: This retrospective cohort study in 2 integrated health plans included patients with incident hypertension in whom treatment was begun between 2002 and 2006. Patients were followed up for the development of resistant hypertension based on AHA criteria of uncontrolled blood pressure despite use of ≥3 antihypertensive medications, with data collected on prescription filling information and blood pressure measurement. We determined incident cardiovascular events (death or incident myocardial infarction, heart failure, stroke, or chronic kidney disease) in patients with and without resistant hypertension with adjustment for patient and clinical characteristics. Among 205 750 patients with incident hypertension, 1.9% developed resistant hypertension within a median of 1.5 years from initial treatment (0.7 cases per 100 person-years of follow-up). These patients were more often men, were older, and had higher rates of diabetes mellitus than nonresistant patients. Over 3.8 years of median follow-up, cardiovascular event rates were significantly higher in those with resistant hypertension (unadjusted 18.0% versus 13.5%, P<0.001). After adjustment for patient and clinical characteristics, resistant hypertension was associated with a higher risk of cardiovascular events (hazard ratio, 1.47; 95% confidence interval, 1.33-1.62).
CONCLUSIONS: Among patients with incident hypertension in whom treatment was begun, 1 in 50 patients developed resistant hypertension. Patients with resistant hypertension had an increased risk of cardiovascular events, which supports the need for greater efforts toward improving hypertension outcomes in this population.
Authors:
Stacie L Daugherty; J David Powers; David J Magid; Heather M Tavel; Frederick A Masoudi; Karen L Margolis; Patrick J O'Connor; Joe V Selby; P Michael Ho
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-02-29
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-04     Completed Date:  2012-05-18     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1635-42     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Colorado-Denver, 12605 E 16th Ave., Aurora, CO 80045, USA. stacie.daugherty@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension / diagnosis*,  epidemiology*,  therapy
Incidence
Male
Middle Aged
Prognosis
Retrospective Studies
Grant Support
ID/Acronym/Agency:
K08 HL103776/HL/NHLBI NIH HHS; K08 HL103776-02/HL/NHLBI NIH HHS; K08HL103776/HL/NHLBI NIH HHS; U19HL91179-01/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Circulation. 2012 Apr 3;125(13):1594-6   [PMID:  22379111 ]

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


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