Prevalence and Clinical Characteristics of Refractory Hypertension

Background- We aimed to estimate the prevalence of refractory hypertension (RfH) and to determine the clinical differences between these patients and resistant hypertensives (RH). Secondly, we assessed the prevalence of white-coat RfH and clinical differences between true- and white-coat RfH patient...

Descripción completa

Detalles Bibliográficos
Autores: Armario García, Pedro, Calhoun, David A., Oliveras Martínez, Anna, Blanch, Pedro, Vinyoles, Ernest, Banegas Banegas, José Ramón, Gorostidi, Manuel, Segura, Julian, Ruilope, L. M., Dudenbostel, Tanja, Sierra, Alejandro de la
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/122908
Acceso en línea:https://hdl.handle.net/2445/122908
Access Level:acceso abierto
Palabra clave:Hipertensió
Malalties cardiovasculars
Hypertension
Cardiovascular diseases
id ES_07105a8a54cc119282ee0c6dfb3f8ade
oai_identifier_str oai:diposit.ub.edu:2445/122908
network_acronym_str ES
network_name_str España
repository_id_str
spelling Prevalence and Clinical Characteristics of Refractory HypertensionArmario García, PedroCalhoun, David A.Oliveras Martínez, AnnaBlanch, PedroVinyoles, ErnestBanegas Banegas, José RamónGorostidi, ManuelSegura, JulianRuilope, L. M.Dudenbostel, TanjaSierra, Alejandro de laHipertensióMalalties cardiovascularsHypertensionCardiovascular diseasesBackground- We aimed to estimate the prevalence of refractory hypertension (RfH) and to determine the clinical differences between these patients and resistant hypertensives (RH). Secondly, we assessed the prevalence of white-coat RfH and clinical differences between true- and white-coat RfH patients. Methods and Results- The present analysis was conducted on the Spanish Ambulatory Blood Pressure Monitoring Registry database containing 70 997 treated hypertensive patients. RH and RfH were defined by the presence of elevated office blood pressure (≥140 and/or 90 mm Hg) in patients treated with at least 3 (RH) and 5 (RfH) antihypertensive drugs. White-coat RfH was defined by RfH with normal (<130/80 mm Hg) 24-hour blood pressure. A total of 11.972 (16.9%) patients fulfilled the standard criteria of RH, and 955 (1.4%) were considered as having RfH. Compared with RH patients, those with RfH were younger, more frequently male, and after adjusting for age and sex, had increased prevalence of target organ damage, and previous cardiovascular disease. The prevalence of white coat RfH was lower than white-coat RH (26.7% versus 37.1%, P<0.001). White-coat RfH, in comparison with those with true RfH, showed a lower prevalence of both left ventricular hypertrophy (22% versus 29.7%; P=0.018) and microalbuminuria (28.3% versus 42.9%; P=0.047). Conclusions- The prevalence of RfH was low and these patients had a greater cardiovascular risk profile compared with RH. One out of 4 patients with RfH have normal 24-hour blood pressure and less target organ damage, thus indicating the important role of ambulatory blood pressure monitoring in guiding antihypertensive therapy in difficult-to-treat patients.2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/122908Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1161/JAHA.117.007365Journal Of The American Heart Association, 2017, vol. 6, num. 12, p. e007365https://doi.org/10.1161/JAHA.117.007365cc-by-nc (c) Armario, Pedro et al., 2017http://creativecommons.org/licenses/by-nc/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1229082026-05-27T06:46:51Z
dc.title.none.fl_str_mv Prevalence and Clinical Characteristics of Refractory Hypertension
title Prevalence and Clinical Characteristics of Refractory Hypertension
spellingShingle Prevalence and Clinical Characteristics of Refractory Hypertension
Armario García, Pedro
Hipertensió
Malalties cardiovasculars
Hypertension
Cardiovascular diseases
title_short Prevalence and Clinical Characteristics of Refractory Hypertension
title_full Prevalence and Clinical Characteristics of Refractory Hypertension
title_fullStr Prevalence and Clinical Characteristics of Refractory Hypertension
title_full_unstemmed Prevalence and Clinical Characteristics of Refractory Hypertension
title_sort Prevalence and Clinical Characteristics of Refractory Hypertension
dc.creator.none.fl_str_mv Armario García, Pedro
Calhoun, David A.
Oliveras Martínez, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas Banegas, José Ramón
Gorostidi, Manuel
Segura, Julian
Ruilope, L. M.
Dudenbostel, Tanja
Sierra, Alejandro de la
author Armario García, Pedro
author_facet Armario García, Pedro
Calhoun, David A.
Oliveras Martínez, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas Banegas, José Ramón
Gorostidi, Manuel
Segura, Julian
Ruilope, L. M.
Dudenbostel, Tanja
Sierra, Alejandro de la
author_role author
author2 Calhoun, David A.
Oliveras Martínez, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas Banegas, José Ramón
Gorostidi, Manuel
Segura, Julian
Ruilope, L. M.
Dudenbostel, Tanja
Sierra, Alejandro de la
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hipertensió
Malalties cardiovasculars
Hypertension
Cardiovascular diseases
topic Hipertensió
Malalties cardiovasculars
Hypertension
Cardiovascular diseases
description Background- We aimed to estimate the prevalence of refractory hypertension (RfH) and to determine the clinical differences between these patients and resistant hypertensives (RH). Secondly, we assessed the prevalence of white-coat RfH and clinical differences between true- and white-coat RfH patients. Methods and Results- The present analysis was conducted on the Spanish Ambulatory Blood Pressure Monitoring Registry database containing 70 997 treated hypertensive patients. RH and RfH were defined by the presence of elevated office blood pressure (≥140 and/or 90 mm Hg) in patients treated with at least 3 (RH) and 5 (RfH) antihypertensive drugs. White-coat RfH was defined by RfH with normal (<130/80 mm Hg) 24-hour blood pressure. A total of 11.972 (16.9%) patients fulfilled the standard criteria of RH, and 955 (1.4%) were considered as having RfH. Compared with RH patients, those with RfH were younger, more frequently male, and after adjusting for age and sex, had increased prevalence of target organ damage, and previous cardiovascular disease. The prevalence of white coat RfH was lower than white-coat RH (26.7% versus 37.1%, P<0.001). White-coat RfH, in comparison with those with true RfH, showed a lower prevalence of both left ventricular hypertrophy (22% versus 29.7%; P=0.018) and microalbuminuria (28.3% versus 42.9%; P=0.047). Conclusions- The prevalence of RfH was low and these patients had a greater cardiovascular risk profile compared with RH. One out of 4 patients with RfH have normal 24-hour blood pressure and less target organ damage, thus indicating the important role of ambulatory blood pressure monitoring in guiding antihypertensive therapy in difficult-to-treat patients.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/122908
url https://hdl.handle.net/2445/122908
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1161/JAHA.117.007365
Journal Of The American Heart Association, 2017, vol. 6, num. 12, p. e007365
https://doi.org/10.1161/JAHA.117.007365
dc.rights.none.fl_str_mv cc-by-nc (c) Armario, Pedro et al., 2017
http://creativecommons.org/licenses/by-nc/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc (c) Armario, Pedro et al., 2017
http://creativecommons.org/licenses/by-nc/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869402955971559424
score 15,301603

Similares en LA Referencia