DOI: 10.1097/01.hjh.0000379173.96487.64
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Issn Print: 0263-6352
Publication Date: 2010/06/01
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Abstract
Objective:To determine the factors associated with resistant hypertension (HTN).
Methods:We selected a sample of 96 consecutive patients attending a HTN consultation in a public hospital. We collected data on demographic variables, cardiometabolic diseases, antihypertensive, statins and antithrombotic drugs. Age was grouped in less than 65 and 65 years or older. Obesity was defined as a body mass index equal or greater to 30. Resistant HTN was considered as blood pressure above 140/90mmHg in the last visit in spite the use of 3 or more antihypertensive agents of different classes (including a diuretic) or blood pressure controlled with four or more medications. The Student t test was used for analyzing continuous variables and the chi-square for categorical variables. A P < 0.05 was considered significant. Statistical analysis was performed using SPSS.
Results:Forty nine participants (51%) were females; mean age was 57.1 ± 14.4 years. HTN was classified as secondary in 24 (26.1%). Prevalence of resistant HTN was 35.4%, similar in males (36.2%) and females (34.7%), more frequent in older than younger (51.6% Vs 27.7%, P = .02). It was similar in secondary (20.8%) and essential HTN (39.7%). Resistant HTN was more frequent in obese patients (50% Vs 27.3%, P = .04) and in patients with diabetes (50% Vs 28.1%, P = .03), kidney disease (53.6% Vs 27.9%, P = .017) and heart failure (63.6% Vs 31.8%, P = .043). Though not significant it was more frequent in patients with peripheral arterial (71.4% Vs 32.6%), coronary (60% Vs 34.1%), cerebrovascular diseases (45% Vs 32.9%), dyslipidemia (39.7% Vs 27.3%) and obstructive sleep apnea (46.7% Vs 33.3%). Use of statins (46.3% Vs 23.1%, P = .018) was more frequent in patients with resistant HTN, but not use of antithrombotic drugs (47.2% Vs 30.4%).
Conclusions:Prevalence of resistant HTN in a specialized HTN consultation was 35.4%, similar as found in other studies. In our study resistant HTN was associated with older age, obesity, diabetes, kidney disease and heart failure. Use of statins was more likely in patients with resistant HTN.
