Apparent and true resistant hypertension: definition, prevalence and outcomes

Judd, Eric; Calhoun, David A.

doi:10.1038/jhh.2013.140

Cited by 225 publications

(195 citation statements)

References 33 publications

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“…Nevertheless, their therapeutic effectiveness in lowering BP is well-recognised in the treatment of resistant hypertension (RH). It has been reported that 10.1% of patients treated for elevated BP failed to attain target BP levels despite widespread use of conventional antihypertensive therapy [26]. According to cross-sectional analysis of the United States National Health and Nutrition Examination Survey (NHANES), the prevalence of patients who met the criteria for RH (defined by systolic and diastolic BP ≥ 140/90 mmHg and reported use of three different drug classes or drugs from ≥ four antihypertensive drug classes irrespective of BP levels) has doubled, reaching 11.8% in 2006 compared to 5.5% in the years 1998-2004 [3].…”

Section: Choice Of Antihypertensive Drugsmentioning

confidence: 99%

Comparison of hypertension epidemiology and treatment in Poland and Australia

Hering

Szymański

2018

Kardiol Pol

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INTRODUCTIONHypertension remains the leading preventable worldwide cause of premature cardiovascular (CV) morbidity and mortality. The risk for stroke, heart disease, and kidney and peripheral damage increases in a linear fashion with blood pressure (BP) levels across all age groups in both men and women. Although the benefits of reducing major CV events through BP control are well-recognised, the management of hypertension continues to be a major global challenge. The unmet need for improvements in hypertension detection and treatment have been raised globally, resulting in the multinational Prospective Urban Rural Epidemiology (PURE) study [1]. Amongst 142,042 adults from 628 communities including high-income, upper-middle, low-middle and low-income countries, only 46.5% of participants were aware of their high BP levels, of whom less than half (40.6%) were receiving antihypertensive treatment, and only one in three (13.2%) individuals had achieved BP control < 140/90 mmHg [1]. The global disparities in hypertension prevalence, awareness, treatment, and control have been further detailed in a recent meta-analysis of 135 population-based studies including 968,419 adults from 90 countries [2]. In 2010, 31.1% of the worldwide adult population had elevated BP with a higher age-standardised prevalence of hypertension in low and middle-income countries (31.5%) compared to high-income countries (28.5%). Globally, the number of adults with hypertension reached an estimated total of 1.39 billion in 2010, including 349 million in high-income countries and 1.04 billion in low and middle-income countries. The highest prevalence and increase in prevalence of raised BP has been observed particularly in East Asia and the Pacific, Latin America and the Caribbean, South Asia, and sub-Saharan

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Section: Choice Of Antihypertensive Drugsmentioning

confidence: 99%

Comparison of hypertension epidemiology and treatment in Poland and Australia

Hering

Szymański

2018

Kardiol Pol

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“…The variability of prevalence can be attributed to patient selection and, more importantly, to the capability to rule out pseudoresistance caused by white-coat hypertension, nonadherence and suboptimal dosing. In a recent pooled analysis, prevalence rate of 10.1 % was found for uncontrolled resistant hypertension among individuals treated for hypertension (8).…”

Section: Introductionmentioning

confidence: 99%

Predictors of blood pressure control in patients with resistant hypertension

Pales¹,

Kamenský²,

Payer³

2017

BLL

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BACKGROUND: Uncontrolled resistant hypertension (RH) defi ned by the mean 24-hour ambulatory blood pressure (ABPM) represents an independent risk factor in hypertensive patients. Predictors of blood pressure (BP) control in RH are not yet clearly defi ned. OBJECTIVES: To evaluate the predictors of BP control in RH patients with repeated ABPM measurements. METHODS: 114 consecutive patients from outpatient cardiology offi ce fulfi lling criteria for RH (offi ce BP ≥ 140 and/or 90 mmHg, with treatment of ≥ 3 antihypertensive drugs, including diuretic, or controlled BP with > 3 drugs), with two consecutive ABPM studies were compared in clinical characteristics according to BP control assessed by ABPM RESULTS: After the second ABPM, BP was controlled in 25.4 % of patients; the remaining 74.6 % were classifi ed as uncontrolled. In the uncontrolled BP group, systolic offi ce BP was 140.91±16.71 mmHg, diastolic 81.26 ± 10.92 mmHg. In ABPM, systolic was 145.11 ± 13.65 mmHg, diastolic 81.26 ± 10.92 mmHg. Compared to the controlled BP group, in the uncontrolled group the age was higher 72.32 ±10.89 years (p = 0.047), baseline average real variability of systolic BP was lower 12.66 ± 3.08 vs. 14.52 ± 3.53 (p = 0.013), no signifi cant difference in baseline standard deviation of systolic BP changes was found. CONCLUSION: Higher offi ce BP, older age, and increased short term BP variability were associated with an uncontrolled hypertension. Stronger association was found with baseline average real variability rather than standard deviation. No signifi cant differences were found in the dipping status and other clinical characteristics (Tab. 6, Fig. 1, Ref. 28). Text in PDF www.elis.sk. KEY WORDS: resistant hypertension, ambulatory blood pressure monitoring, blood pressure variability.

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“…Uma melhor compreensão da ocorrência e resultados associados à hipertensão resistente e pseudorresistente é importante para melhorar a gestão desses pacientes, possibilitando um melhor tratamento e podendo evitar possíveis danos ao individuo hipertenso (11,12). Este estudo teve como objetivo identificar a HAR e a hipertensão pseudorresistente em pacientes atendidos em uma Unidade de Saúde da Família.…”

Section: Introductionunclassified

Identificação De Pacientes Com Hipertensão Resistente E Pseudorresistente Em Uma Unidade De Saúde Da Família

Silva¹,

Amorim²,

Filho³

et al. 2017

Infarma

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Resistant Hypertension manifests when blood pressure (BP) remains above the recommended levels, despite regular use of three classes of antihypertensive drugs, including diuretics. This study aimed to identify resistant hypertension and pseudo-resistant hypertension in patients enrolled in a Family Health Unit. It was a cross-sectional study in hypertensive patients using antihypertensive medications seen at Basic Health Unit (BHU), located in the city of Maceio, through interviews with a structured questionnaire during home visits, as well as searching information from patients medical records at BHU. Patients were monitored for three consecutive weeks. The adherence was determined by applying the Morisky Adherence Scale Therapeutics eight items (MMAS-8). The antihypertensive drug therapy was evaluated according to the Brazilian Guidelines on Hypertension. Fifty 50 patients were investigated, with mean age of 66.4 years (SD = 13.5). Most hypertensive patients studied were female (74%). Among the patients, 39 were classified as pseudo-resistant hypertension (78%), and 28 patients used antihypertensive regimens are considered inappropriate and 11 were non-adherent to treatment. In this study, 8% of hypertensive patients were diagnosed with resistant hypertension. Regarding SBP and DBP, gender, smoking habits and physical activity were not influencing factors. On the other hand, the proper prescription was correlated with the control of SBP, but not with the DBP control. The degree of adherence influenced both SBP and DBP. It was also observed the influence of subtype of hypertension on the SBP and DBP.Key Words: medication adherence; hypertension; inappropriate prescribing RESUMO A Hipertensão Resistente (HAR) se manifesta quando os valores de pressão arterial (PA) permanecem acima da meta, apesar do uso regular de três classes de fármacos anti-hipertensivos, incluindo um diurético. Este estudo teve como objetivo identificar a HAR e a hipertensão pseudo-resistente em pacientes atendidos em uma Unidade de Saúde da Família. Foi realizado um estudo transversal com pacientes hipertensos em uso de medicamentos anti-hipertensivos atendidos em uma Unidade Básica de Saúde localizada no município de Maceió, por meio de entrevistas, com aplicação de questionário estruturado durante visitas domiciliares. Os valores de PA dos pacientes foram monitorados durante três semanas consecutivas. A adesão terapêutica foi determinada por meio da aplicação da Escala de Adesão Terapêutica de oito itens de Morisky (MMAS-8). Foram investigados 50 pacientes, com média de idade de 66,4 anos (DP = 13,5), sendo que a maioria dos pacientes era do sexo feminino (74%). Entre os pacientes estudados, 39 foram

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Apparent and true resistant hypertension: definition, prevalence and outcomes

Cited by 225 publications

References 33 publications

Comparison of hypertension epidemiology and treatment in Poland and Australia

Comparison of hypertension epidemiology and treatment in Poland and Australia

Predictors of blood pressure control in patients with resistant hypertension

Identificação De Pacientes Com Hipertensão Resistente E Pseudorresistente Em Uma Unidade De Saúde Da Família

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