Document Detail


Prevalence of resistant hypertension in the United States, 2003-2008.
MedLine Citation:
PMID:  21502568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of resistant hypertension is unknown. Much previous knowledge comes from referral populations or clinical trial participants. Using data from the National Health and Nutrition Examination Survey from 2003 through 2008, nonpregnant adults with hypertension were classified as resistant if their blood pressure was ≥140/90 mm Hg and they reported using antihypertensive medications from 3 different drug classes or drugs from ≥4 antihypertensive drug classes regardless of blood pressure. Among US adults with hypertension, 8.9% (SE: 0.6%) met criteria for resistant hypertension. This represented 12.8% (SE: 0.9%) of the antihypertensive drug-treated population. Of all drug-treated adults whose hypertension was uncontrolled, 72.4% (SE: 1.6%) were taking drugs from <3 classes. Compared with those with controlled hypertension using 1 to 3 medication classes, adults with resistant hypertension were more likely to be older, to be non-Hispanic black, and to have higher body mass index (all P<0.001). They were more likely to have albuminuria, reduced renal function, and self-reported medical histories of coronary heart disease, heart failure, stroke, and diabetes mellitus (P<0.001). Most (85.6% [SE: 2.4%]) individuals with resistant hypertension used a diuretic. Of this group, 64.4% (SE: 3.2%) used the relatively weak thiazide diuretic hydrochlorothiazide. Although not rare, resistant hypertension is currently found in only a modest proportion of the hypertensive population. Among those classified here as resistant, inadequate diuretic therapy may be a modifiable therapeutic target. Cardiovascular diseases, diabetes mellitus, obesity, and renal dysfunction were all common in this population.
Authors:
Stephen D Persell
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2011-04-18
Journal Detail:
Title:  Hypertension     Volume:  57     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-19     Completed Date:  2011-07-22     Revised Date:  2011-10-21    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1076-80     Citation Subset:  IM    
Affiliation:
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr, 10th Floor, Chicago, IL 60611, USA. spersell@nmff.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / classification,  therapeutic use*
Blood Pressure / drug effects*
Cardiovascular Diseases / physiopathology
Drug Resistance
Drug Therapy / methods,  statistics & numerical data
Humans
Hypertension / drug therapy*,  epidemiology,  physiopathology*
Nutrition Surveys / statistics & numerical data
Prevalence
Risk Assessment
Risk Factors
United States / epidemiology
Grant Support
ID/Acronym/Agency:
1K08HS015647-01/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
Hypertension. 2011 Oct;58(4):e23; author reply e24-5   [PMID:  21825223 ]
Hypertension. 2011 Jun;57(6):1045-6   [PMID:  21502566 ]

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


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