Prevalence of resistant hypertension and associated factors for blood pressure control status using Korean ambulatory blood pressure monitoring registry data

Abstract

BackgroundResistant hypertension (RH) may be one of the cause of the plateau in improving the control rate in hypertension (HT) management. The misdiagnosis of RH by clinic blood pressure (BP) is important clinical problem. Aim of the study were to investigate the prevalence of RH by ambulatory blood pressure monitoring (ABPM) and the factor associated with control status of ambulatory BPs.MethodsFor 1230 subjects taking one or more antihypertensive medication (AHM) enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, the prevalence of RH was calculated which was defined as uncontrolled BP by three AHM classes including diuretic or BP in need of four or more AHM classes. The prevalence determined by clinic versus ambulatory BP was compared.ResultsThe age was 59.3 ± 12.5 years, and 44.3 % were female (n = 1230). Among them 72 subjects were taking three AHM drugs including diuretics and 105 subjects were taking four or more AHM classes. With uncontrolled daytime ambulatory BP in 41 among 72 subjects, prevalence of RH was 11.9 % (146/1230). By using nighttime BP criteria, there was significant difference in the prevalence of RH for clinic versus nighttime BP (146/177 vs. 159/177, p = 0.0124). For control status of daytime BP, masked uncontrolled BP was 16.9 % and controlled BP with white-coat effect was 14.1 %. For nighttime BP control status, odd ratios for smoking (0.624), drinking (1.512), coronary artery disease (0.604), calcium antagonist (1.705), and loop diuretics (0.454) were all significant.ConclusionThe prevalence itself was 11.9 % by daytime BP and it was significantly higher when using nighttime BP criteria. Control status of daytime BP was misclassified in 31.0 %. Smoking, drinking, coronary artery disease, calcium antagonist, and loop diuretics were associated with nighttime BP control status.

Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study

“…Hypertension patients who drank regularly were less likely to have their BP under control. A Korean study discovered the adverse effects of drinking was significant for uncontrolled BP both at nighttime and over 24 h [ 37 ]. In fact, heavy drinking itself can be associated with resistant hypertension [ 38 ].…”

Association between different methods of assessing blood pressure variability and incident cardiovascular disease, cardiovascular mortality and all-cause mortality: a systematic review

“…[34] Follow-up interval ranged from 12 months [9,35,36] to 20 years. [37] Thirty-nine studies were conducted in a hospital setting, [4,8,10,11,14,15,19,25,31,[33][34][35][36][38][39][40][41][42][43][44][45][46][47][48][49][50][52][53][54][55][56][57][58][59][60][61]64,69,71] whilst 21 studies were conducted in the community. [1-3,,5,6,9,12,13,16,20,21,30,37,51,62,63,65-68,70] -This was not documented in one paper.…”

“…Thirty studies (49%) measured blood pressure over 24 to 26 hours (short-term) using ambulatory BP monitors, [1][2][3][4][5][6][8][9][10][11][12][14][15][16][17]33,[35][36][37]40,42,52,54,57,60,61,63,65,67,69]; in 34 studies (56%), 'day-byday' variability was determined in participants who self-measured blood pressure for 7-28 days with home blood pressure monitors (HBPM) (long-term). [8,13,[19][20][21]25,30,31,[34][35][36]38,39,41,[43][44][45][46][47][48][49]…”

“…Six studies reported the presence of associations with diastolic BPV (DBPV) and cardiovascular events, while four studies reported no association. SD was employed by 22 studies to estimate SBPV of which 17 demonstrated positive results, [1,3,4,6,8,9,11,12,14,17,33,35,37,40,57,60,69] while five were negative. [ 10,36,54,61,63,] Ten studies also evaluated SD-DBPV of which six [6,8,11,17,37,69] were positive and four were negative.…”

Erratum to: Prevalence of resistant hypertension and associated factors for blood pressure control status using Korean ambulatory blood pressure monitoring registry data

“…After the publication of the original article [ 1 ], it was brought to our attention that a number of grammatical corrections had not been implemented as requested by the author. The title has been corrected from ‘Prevalence of resistant hypertension and associated factors for blood pressure control status with optimal medical therapy using Korean ambulatory blood pressure monitoring registry data’ to ‘Prevalence of resistant hypertension and associated factors for blood pressure control status using Korean ambulatory blood pressure monitoring registry data’.…”