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...

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Autores: Armario, Pedro, Calhoun, David A., Oliveras, Anna, Blanch, Pedro, Vinyoles, Ernest, Banegas, Jose R., Gorostidi, Manuel, Segura, Julián, Ruilope, Luis Miguel, Dudenbostel,Tanja, Sierra, Alejandro de la
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/35869
Acceso en línea:http://hdl.handle.net/10230/35869
http://dx.doi.org/10.1161/JAHA.117.007365
Access Level:acceso abierto
Palabra clave:Hipertensió
Refractory hypertension
Resistant hypertension
Target organ damage
White coat refractory hypertension
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spelling Prevalence and clinical characteristics of refractory hypertensionArmario, PedroCalhoun, David A.Oliveras, AnnaBlanch, PedroVinyoles, ErnestBanegas, Jose R.Gorostidi, ManuelSegura, JuliánRuilope, Luis MiguelDudenbostel,TanjaSierra, Alejandro de laHipertensióRefractory hypertensionResistant hypertensionTarget organ damageWhite coat refractory hypertensionBACKGROUND: 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.Wiley201820182017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/35869http://dx.doi.org/10.1161/JAHA.117.007365reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésJournal of the American Heart Association. 2017 Dec 7;6(12):e007365Copyright © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the https://creativecommons.org/licenses/by-nc-nd/4.0/, Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/358692026-05-29T05:05:01Z
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, Pedro
Hipertensió
Refractory hypertension
Resistant hypertension
Target organ damage
White coat refractory hypertension
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, Pedro
Calhoun, David A.
Oliveras, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas, Jose R.
Gorostidi, Manuel
Segura, Julián
Ruilope, Luis Miguel
Dudenbostel,Tanja
Sierra, Alejandro de la
author Armario, Pedro
author_facet Armario, Pedro
Calhoun, David A.
Oliveras, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas, Jose R.
Gorostidi, Manuel
Segura, Julián
Ruilope, Luis Miguel
Dudenbostel,Tanja
Sierra, Alejandro de la
author_role author
author2 Calhoun, David A.
Oliveras, Anna
Blanch, Pedro
Vinyoles, Ernest
Banegas, Jose R.
Gorostidi, Manuel
Segura, Julián
Ruilope, Luis Miguel
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
Refractory hypertension
Resistant hypertension
Target organ damage
White coat refractory hypertension
topic Hipertensió
Refractory hypertension
Resistant hypertension
Target organ damage
White coat refractory hypertension
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
2018
2018
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 http://hdl.handle.net/10230/35869
http://dx.doi.org/10.1161/JAHA.117.007365
url http://hdl.handle.net/10230/35869
http://dx.doi.org/10.1161/JAHA.117.007365
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Journal of the American Heart Association. 2017 Dec 7;6(12):e007365
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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