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Cited by 409Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionSodium Intake and Health

Cardiovascular Outcome in Treated Hypertensive Patients with Responder, Masked, False Resistant, and True Resistant Hypertension

PIERDOMENICO, S, LAPENNA, D, BUCCI, A, DITOMMASO, R, DIMASCIO, R, MANENTE, B, CALDARELLA, M, NERI, M +2 more·2005·American Journal of Hypertension
DOI 10.1016/j.amjhyper.2005.05.014
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Abstract

BACKGROUND: The aim of this study was to evaluate the cardiovascular outcome in apparently responder hypertensive patients with responder and masked hypertension, and in apparently resistant hypertensive patients with false and true resistant hypertension. METHODS: The occurrence of fatal and nonfatal cardiovascular events was evaluated in 340 patients with responder hypertension (clinic blood pressure [BP] <140/90 mm Hg and daytime BP <135/85 mm Hg), 126 with masked hypertension (clinic BP <140/90 mm Hg and daytime BP >135 or 85 mm Hg), 146 with false resistant hypertension (clinic BP >or=140 or 90 mm Hg and daytime BP <135/85 mm Hg), and 130 with true resistant hypertension (clinic BP >or=140 or 90 mm Hg and daytime BP >135 or 85 mm Hg). RESULTS: During follow-up period (4.98 +/- 2.9 years), the event-rate per 100 patient-years was 0.87, 2.42, 1.2, and 4.1 in patients with responder, masked, false resistant, and true resistant hypertension, respectively. After adjustment for several covariates, including clinic BP (forced into the model), Cox regression analysis showed that cardiovascular risk was significantly higher in masked hypertension (masked versus responder hypertension, relative risk [RR] 2.28, 95% confidence interval [CI] 1.1-4.7, P < .05) and in true resistant hypertension (true resistant versus responder hypertension, RR 2.94, 95% CI 1.02-8.41, P < .05), whereas there was no significant difference between false resistant and responder hypertension. CONCLUSIONS: This study shows that patients with masked hypertension are at higher risk than those with responder hypertension, and that those with false resistant hypertension are at lower risk than those with true resistant hypertension. Ambulatory BP monitoring should be performed in treated hypertensive patients to obtain a better prognostic stratification.

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  • Prospective studies using ambulatory blood pressure monitoring have suggested an almost 2-fold increased risk of cardiovascular disease events in patients with true resistant hypertension compared with those with hypertension responsive to treatment.

    “Prospective studies using ABPM have suggested an almost 2-fold increased risk of CVD events in patients with true RH compared with those with hypertension responsive to treatment.30–33”

    From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [31]

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Authors
PIERDOMENICO, S., LAPENNA, D., BUCCI, A., DITOMMASO, R., DIMASCIO, R., MANENTE, B., CALDARELLA, M., NERI, M., CUCCURULLO, F., & MEZZETTI, A.
Affiliations
University of Chieti-Pescara (IT)
ORCID
Venue
American Journal of Hypertension
Publisher
Oxford University Press (OUP)
Published
2005-11
Volume
18
Issue
11
Pages
1422-1428
ISSN
0895-7061 (ISSN-L)
DOI
10.1016/j.amjhyper.2005.05.014
OpenAlex
W2007701939
Cited by
409
References
29
Citations by year
2026: 4 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 10 · 2021: 14 · 2020: 20 · 2019: 15 · 2018: 16 · 2017: 23 · 2016: 28 · 2015: 31 · 2014: 47 · 2013: 42 · 2012: 19
FWCI
12.99
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
masked hypertension, resistant hypertension, cardiovascular events, ambulatory blood pressure monitoring, antihypertensive therapy, cardiovascular risk stratification
MeSH terms
Aged, Blood Pressure, Blood Pressure Determination, Cardiovascular Diseases, Drug Resistance, Female, Humans, Hypertension, Male, Middle Aged, Regression Analysis, Proportional Hazards Models, Treatment Outcome, Disease-Free Survival, Blood Pressure Monitoring, Ambulatory

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