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To determine whether the target organ damage is different from patient with refractory hypertension in comparison with well-controlled hypertensive patients in a hospital hypertension unite.

Design and Method:

Hypertensive patients treated with three or more antihypertensive drugs including a diuretic, were classifi ed into two groups: RHBP: patients with blood pressure (BP)>140 and /or 90 mmHg in the last two visits; and HTAC group: patients with BP<140 and 90 mmHg in the last two visits. It was determined: fasting glucose, lipid profi le, uric acid, serum creatinine, creatinine clearance and microalbuminuria. Fundus, echocardiography,electrocardiogram and ambulatory blood pressure monitoring.


62 patients were included in the study, 38 in the refractory group. The media of the ambulatory blood pressure monitoring was 146 8/87 11 mmHg in the refractory group versus 121 4/74 5 mmHg). in the controlled group (p = 0.001). Target organ damage,the prevalence of LVH was 76% in the refractory group versus 29% in the controlled group (p = 0.001). The prevalence of albumin in 24hours = 30 mg/24 hours was 26.3 in the refractory group and 4.2% in the controlled group (p = 0.026)Eye fundus examinations, in the refractory group 89.5% had grade II and 10% had grade III. In the controlled group 12.5% had normal fundus examinations and 87.5 had grade II (p = 0.001).


Upon entry into the Unit, HTAr patients had similar levels of PA patients with HTAc, but have a signifi cantly increased cardiovascular risk. The prevalence of cardiovascular disease and organ damage cardiac renal and cerebral was signifi cantly higher in the refractory group than that of the controlled group.

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