Resistant Hypertension: A Frequent and Ominous Finding Among Hypertensive Patients With Atherothrombosis

Kumbhani, Dharam J.; Steg, Philippe Gabríel; Cannon, Christopher P.; Eagle, Kim A.; Smith, Sidney; Crowley, Kevin; Goto, Shinichi; Ohman, E. Magnus; Bakris, George; Perlstein, Todd S.; Kinlay, Scott; Bhatt, Deepak L.

doi:10.1016/s0735-1097(12)61734-3

Cited by 12 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been demonstrated that patients with concentric hypertrophy have poorer outcomes than patients presenting normal LV geometry. 3,4 Resistant hypertension (RHTN) is of major clinical importance since it is associated with higher cardiovascular risk [5][6][7][8] which can be dependent on concentric hypertrophy. However, RHTN often coexists with obstructive sleep apnea (OSA) 9,10 and metabolic syndrome (MS), which also predispose to LVH.…”

Section: Introductionmentioning

confidence: 99%

Determinants of concentric left ventricular hypertrophy in patients with resistant hypertension: RESIST-POL study

et al. 2015

View full text Add to dashboard Cite

Left ventricular hypertrophy, especially concentric hypertrophy, has been shown to be an independent factor of cardiovascular diseases in patients with hypertension. Obstructive sleep apnea (OSA) and/or metabolic syndrome (MS) are common in patients with resistant hypertension (RHTN). The aim of this study was to evaluate factors associated with concentric hypertrophy in patients with RHTN. Data from 155 patients (92M, 63F) was analyzed. All patients underwent a thorough examination including: biochemical evaluations, ambulatory blood pressure monitoring, polysomnography and echocardiography. MS was defined by The Adult Treatment Panel III. Clinically significant OSA was defined as apnea/hypopnea index (AHI)>15 events per hour. Left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated. Four types of LV geometry were distinguished based on the LVMI and RWT. Patients were divided into four groups based on the LV geometric patterns: group 1 (normal geometry) (n=38, 24.4%); group 2 (concentric remodeling) (n=40, 25.8%); group 3 (eccentric hypertrophy) (n=26, 16.8%); and group 4 (concentric hypertrophy) (n=51, 33%). MS was found in 64% and OSA (AHI>15) in 43.2% of patients. Factors independently associated with concentric hypertrophy were: age (OR-1.51; 95% CI-1.00-2.27; P<0.04), OSA>15 events per hour (OR-2.73; 95% CI-1.26-5.93; P=0.01) and nighttime systolic blood pressure (SBP) (OR-1.69; 95% CI-1.32-2.17; P=0.0001). Concentric hypertrophy was the most common type of left ventricular disorder in patients with RHTN. Nighttime SBP and clinically significant OSA were independently associated with concentric hypertrophy in patients with RHTN.

show abstract

Section: Introductionmentioning

confidence: 99%

Determinants of concentric left ventricular hypertrophy in patients with resistant hypertension: RESIST-POL study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The best target population was deemed to be patients with resistant hypertension uncontrolled on maximal medical therapy. 4 A ''cleaner'' design would have been in patients who were hypertensive and not on medications, but practical and ethical considerations precluded this approach at the time. There were concerns that an invasive and likely expensive procedure could not be justified in lower risk patients without first obtaining more long-term safety data for renal artery denervation than existed at that time.…”

Section: Early Results Of Renal Artery Denervation and The Birth Of Smentioning

confidence: 99%

Future prospects for renal artery denervation

Bhatt

2016

Journal of the American Society of Hypertension

View full text Add to dashboard Cite

“…It was demonstrated that patients with TRH had a higher risk of the primary composite endpoint (HR 1.11, 95 % CI 1.02-1.20, p = 0.017), including CV death, myocardial infarction and stroke over a follow-up of 4 years, compared to non-TRH patients. Interestingly, this was likely due to differences in non-fatal stroke (TRH: 6.9% versus non-TRH: 5.3 %; HR 1.26, 95 % CI 1.10-1.45, p = 0.0008) [34].…”

Section: Discussionmentioning

confidence: 99%

Retinal microperfusion after renal denervation in treatment-resistant hypertensive patients

et al. 2015

View full text Add to dashboard Cite

In hypertensive patients with TRH, we observed a decrease of pulsed RCF 6 M and 12 M after RDN and an increase of vasodilatory capacity, in parallel to decreases in BP and heart rate. The reduction of pulsed RCF after RDN implies a decrease of shear stress on the vascular wall by the pulsed blood flow. This and the increment of vasodilatory capacity suggest an improvement of retinal (and potentially cerebral) microcirculation.

show abstract

Resistant Hypertension: A Frequent and Ominous Finding Among Hypertensive Patients With Atherothrombosis

Cited by 12 publications

References 0 publications

Determinants of concentric left ventricular hypertrophy in patients with resistant hypertension: RESIST-POL study

Determinants of concentric left ventricular hypertrophy in patients with resistant hypertension: RESIST-POL study

Future prospects for renal artery denervation

Retinal microperfusion after renal denervation in treatment-resistant hypertensive patients

Contact Info

Product

Resources

About