Clinical characteristics of patients with resistant hypertension: the RESIST-POL study
Abstract
Recent studies indicate that resistant hypertension (RHTN) is present in about 12% of the treated hypertensive population. However, patients with true RHTN (confirmed out of the office) have not been widely studied. We prospectively studied 204 patients (123 male, 81 female, mean age 48.4 years, range 19-65 years) with truly RHTN (ambulatory daytime mean blood pressure >135/85 mm Hg). We evaluated the frequency of obstructive sleep apnea (OSA), renal artery stenosis (RAS), primary aldosteronism (PA) and other secondary forms of hypertension (HTN) and conditions. Mild, moderate and severe OSA were present in 55 (27.0%), 38 (18.6%) and 54 (26.5%) patients, respectively. Secondary forms of HTN were diagnosed in 49 patients (24.0%), the most frequent being PA (15.7%) and RAS (5.4%). Metabolic syndrome (MS) was present in 65.7% of patients. Excessive sodium excretion was evident in 33.3% of patients and depression in 36.8% patients. In patients with RHTN, OSA and MS were the most frequent conditions, frequently overlapping with each other and also with PA. Our data indicate that in the vast majority of patients with truly RHTN, at least one of three co-morbidities-OSA, MS and PA-is present. Other conditions, even though less frequent, should also be taken into the consideration.
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In a study of 204 patients with true resistant hypertension confirmed by ambulatory monitoring, one-third displayed evidence for excess sodium intake (24-hour urine levels >200 mEq).
“In a study of 204 patients with true RH confirmed by ambulatory monitoring, one-third displayed evidence for excess sodium intake (ie, 24-hour urine levels >200 mEq).160”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [160]
The majority of studies indicate that primary aldosteronism is a particularly common cause of resistant hypertension.
“The majority of studies indicate that primary aldosteronism is a particularly common cause of RH.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [160]
Observational studies from many different countries have demonstrated a prevalence rate of primary aldosteronism of ≈20% in patients with confirmed resistant hypertension.
“Observational studies from many different countries have demonstrated a prevalence rate of primary aldosteronism of ≈20% in patients with confirmed RH.57,160,294–296”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [160]
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References 44 · Cited by 120
- Authors
- Florczak, E., Prejbisz, A., Szwench-Pietrasz, E., Śliwiński, P., Bieleń, P., Klisiewicz, A., Michałowska, I., Warchoł, E., Januszewicz, M., Kała, M., Witkowski, A., Więcek, A., Narkiewicz, K., Somers, V. K., & Januszewicz, A.
- Affiliations
- Institute of Cardiology (PL)
- Medical University of Warsaw (PL)
- Medical University of Silesia (PL)
- Gdańsk Medical University (PL)
- Mayo Clinic (US)
- Corresponding author
- Prejbisz, A
- ORCID
- Venue
- Journal of Human Hypertension
- Published
- 2013-05-23
- Volume
- 27
- Issue
- 11
- Pages
- 678-685
- ISSN
- 0950-9240 (ISSN-L)
- 1476-5527
- OpenAlex
- W2070556495
- Cited by
- 120
- References
- 44
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 6 · 2020: 18 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 8 · 2015: 10 · 2014: 14 · 2013: 7 · 2012: 1
- FWCI
- 8.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Human Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Society of Cardiology
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- resistant hypertension, obstructive sleep apnea, metabolic syndrome, primary aldosteronism, renal artery stenosis, secondary hypertension, comorbidities, depression, ambulatory blood pressure
- MeSH terms
- Adult, Aged, Antihypertensive Agents, Blood Pressure, Depression, Drug Resistance, Female, Humans, Hyperaldosteronism, Hypertension, Male, Middle Aged, Poland, Prospective Studies, Renal Artery Obstruction, Risk Factors, Severity of Illness Index, Comorbidity, Prevalence, Treatment Failure, Sleep Apnea, Obstructive, Metabolic Syndrome, Young Adult
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