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Resistant hypertension: do all definitions describe the same patients?

Journal of Human Hypertension volume 29, pages 530–534 (2015)Cite this article

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Abstract

Resistant hypertension (RH) is defined as blood pressure (BP) that remains ⩾140 and/or 90 mm Hg despite therapy with ⩾3 full-dose antihypertensive drugs (classical definition=CD). A definition proposed subsequently (new definition=ND) includes patients requiring ⩾4 drugs irrespective of BP values. We aimed to evaluate whether both definitions characterize the same kind of patients.One hundred and twenty-four consecutively attended patients with RH were classified into two groups according to their BP control: 66 patients had non-controlled BP (all those who met the CD criteria plus a few patients who met the ND criteria); 58 patients had controlled BP (all with RH according to the ND). Clinical, laboratory and office BP data were recorded. RH patients with non-controlled BP were more frequently diabetic (72% vs 49%), and had higher plasmatic glucose (149 vs 130 mg dl−1), cholesterol (179 vs 164 mg dl−1), low-density lipoprotein (LDL)-cholesterol (107 vs 95 mg dl−1) and triglyceride (169 vs 137 mg dl−1) levels; P<0.05 for all comparisons. In multivariate logistic regression analysis, the variables that independently associated with non-controlled BP were diabetes (P=0.001) and higher LDL-cholesterol (P=0.007).We conclude that, although both cohorts of patients are phenotypically quite similar, uncontrolled RH patients have higher prevalence of diabetes mellitus and higher LDL-cholesterol levels than controlled RH patients.

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Acknowledgements

We thank Sergi Mojal for his statistical guidance. This study was partially supported by the Spanish scientific research network REDINREN RD12/0021/0024.

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Authors and Affiliations

  1. Faculty of Health and Life Sciences, Universitat Autònoma de Barcelona - Universitat Pompeu Fabra, Barcelona, Spain

    L Boswell, J Pascual & A Oliveras

  2. Nephrology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain

    J Pascual & A Oliveras

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  1. L Boswell
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  2. J Pascual
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Correspondence to A Oliveras.

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Supplementary Information accompanies this paper on the Journal of Human Hypertension website

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Boswell, L., Pascual, J. & Oliveras, A. Resistant hypertension: do all definitions describe the same patients?. J Hum Hypertens 29, 530–534 (2015). https://doi.org/10.1038/jhh.2014.128

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