Relationship of Resistant Hypertension and Treatment Outcomes With Total Arterial Compliance in a Predominantly African American Hypertensive Cohort
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J Clin Hypertens (Greenwich). 2012; 14:618–622. © 2012 Wiley Periodicals, Inc. Resistant hypertension (RH) affects 8% to 30% of hypertensive patients. Blood pressure (BP) reflects the interaction between vascular compliance, resistance to flow, intravascular volume, and cardiac contractility. The relationship of RH with total arterial compliance index (TACI) has not been adequately explored. The RH period prevalence (RH at baseline or follow‐up) was determined in a hypertensive cohort (N=156) and compared across quartiles of TACI. Age‐ and sex‐adjusted systolic BP, diastolic BP, and antihypertensive therapeutic intensity score (TIS) were also determined at the time of first BP control. The cohort was 85.3% African American and 67.3% female. Median follow‐up was 7 months. The prevalence of RH at baseline was 14.7% while the period prevalence was 43.6%. The period prevalence of RH by ascending quartile for TACI was 66%, 36.8%, 40%, and 30.8% (P=.008). The average BP and antihypertensive TIS at first BP control across TACI quartiles was 122.3/73.4 mm Hg (2.26), 120.7/72.5 mm Hg (1.88), 122.4/75.3 mm Hg (1.71), and 120.0/79.4 mm Hg (1.64) (P=.62, P=.03, P=.13). Low TACI was linked to higher RH prevalence and antihypertensive TIS at first attainment of goal BP according to the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. TACI provides prognostic information that is clinically and perhaps pathophysiologically relevant in RH.
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Obesity, left ventricular hypertrophy, albuminuria, diabetes mellitus, chronic kidney disease, higher Framingham 10-year risk score, and obstructive sleep apnea are more common in resistant hypertension than non-resistant hypertension.
“Obesity,39–41 left ventricular hypertrophy,42 albuminuria,14,43 diabetes mellitus,14,38,39 CKD,38,39,44 higher Framingham 10-year risk score,39 and obstructive sleep apnea (OSA)45,46 are more common in RH than non-RH.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [40]
Physiological aberrations in resistant hypertension include vascular disease/dysfunction as evidenced by high rates of peripheral and carotid artery atherosclerosis, impaired endothelial function, reduced arterial compliance, and raised systemic vascular resistance, all of which may be more pronounced in resistant hypertension compared with non-resistant hypertension.
“Physiological aberrations in RH include vascular disease/dysfunction as evidenced by high rates of peripheral39 and carotid artery atherosclerosis,42 impaired endothelial function,51,52 reduced arterial compliance, and raised systemic vascular resistance,40 all of which may be more pronounced in RH compared with non-RH.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [40]
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References 23 · Cited by 14
Research works printed but not linked: 2
- [19]19. Aoka Y. Limitation of monotherapy and benefit of impedance cardiography as a guide for a combination therapy in achieving blood pressure control in essential hypertension. J Clin Hypertens . 2009;11:A21.
- [20]20. Sramek B, Tichy JA, Hojerova M, et al. Normohemodynamic goaloriented antihypertensive therapy improves the outcome. Am J Hypertens . 1996;9:141A.
- Authors
- Bakhtar, O., Ference, B. A., Hedquist, L. A., Levy, P. D., & Flack, J. M.
- Affiliations
- Wayne State University (US)
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2012-05-18
- Volume
- 14
- Issue
- 9
- Pages
- 618-622
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC8108755
- OpenAlex
- W1859248928
- Cited by
- 14
- References
- 23
- Citations by year
- 2025: 1 · 2023: 3 · 2020: 1 · 2018: 4 · 2016: 1 · 2015: 2 · 2014: 2
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Hypertension (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- resistant hypertension, arterial compliance, blood pressure control, period prevalence, prognostic factors, antihypertensive therapy
- MeSH terms
- Antihypertensive Agents, Black or African American, Blood Pressure, Compliance, Female, Follow-Up Studies, Humans, Hypertension, Male, Vascular Resistance, Prevalence
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