| Urinary albumin excretion is associated with true resistant hypertension. | |
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MedLine Citation:
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PMID: 19421225 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Resistant (or refractory) hypertension (RH) is a clinical diagnosis based on blood pressure (BP) office measurements. About one third of subjects with suspected RH have indeed pseudo-resistant hypertension and 24-h ambulatory-blood pressure-monitoring aids to precisely identify them. Our aim was to determine those clinical, laboratory or echocardiographic variables that may be associated with subjects with sustained hypertension (namely true RH). We carried out a cross-sectional analysis of 143 patients consecutively enrolled with the clinical diagnosis of RH. All patients underwent clinical-demographic, laboratory evaluation, 2D-echocardiography and 24-h ambulatory-blood pressure-monitoring. Pseudo-resistant hypertension or white-coat RH was defined if office BP was > or =140 and/or 90 mm Hg and 24-h BP <130/80 mm Hg. One-hundred and three (72%) patients had true RH and 40 (28%) patients had white-coat RH. True RH patients had significantly higher diabetes prevalence and higher office-systolic blood pressure (SBP) levels. Regarding target organ damage, left ventricular mass index (LVMI) and 24-h urinary albumin excretion (UAE) were also higher in true RH after adjustment for possible confounders (P=0.031 and P=0.012, respectively). In a logistic regression analysis, only office-SBP (multivariate OR (95%CI): 1.030 (1.003-1.057), P=0.030) and UAE (multivariate OR (95% CI): 2.376 (1.225-4.608), P=0.010) were independently associated with true RH. We conclude that true resistant hypertension is associated with silent target organ damage, especially UAE. In patients with suspected RH, assessment of 24 h ambulatory BP is the most accurate way to detect a population with high risk for target-organ damage. |
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Authors:
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A Oliveras; P Armario; R Hern?ndez-Del Rey; J A Arroyo; E Poch; M Larrousse; A Roca-Cusachs; A de la Sierra |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of human hypertension Volume: 24 ISSN: 1476-5527 ISO Abbreviation: J Hum Hypertens Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-16 Completed Date: 2010-02-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 27-33 Citation Subset: IM |
Affiliation:
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Nephrology Division, Hypertension Unit, Medicine Department, Hospital Universitari del Mar, Universitat Aut?noma de Barcelona, 08003-Barcelona, Spain. aoliveras@hospitaldelmar.cat |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Albuminuria / physiopathology* Blood Pressure Monitoring, Ambulatory Cross-Sectional Studies Drug Resistance Echocardiography Female Humans Hypertension / drug therapy, physiopathology, urine* Logistic Models Male Middle Aged |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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