Resistant Hypertension and Associated Comorbidities in a Veterans Affairs Population
Open accessAbstract
Resistant hypertension (RH) is understudied and its reported prevalence varies with study populations. The authors sought to determine its prevalence and association with certain comorbid conditions in a Veterans Affairs population. This cross‐sectional study utilized demographic and clinical data from 17,466 patients. Chi‐square or t test was used for comparing groups with and without RH. Multivariate logistic regression analysis was used to determine independent associations. Overall, the prevalence of RH was 9%, and 13% of all hypertensive patients met criteria for RH. After adjusting for confounding variables, RH was significantly associated with older age (odds ratio [OR], 1.007), higher body mass index (OR, 1.04), Framingham score (OR, 1.14), and coexisting coronary artery disease, cerebrovascular accident/transient ischemic attack, peripheral vascular disease, congestive heart failure, chronic kidney disease, diabetes mellitus, erectile dysfunction, and metabolic syndrome (OR, 1.3, 1.32, 1.29, 2.88, 2.13, 1.2, 1.12, and 1.2, respectively; all P<.05). Our results indicate a complex interplay of certain comorbid conditions among patients with RH and suggest the need for multifaceted interventions in this high‐risk population to prevent cardiovascular events.
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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 [39]
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 [39]
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- Authors
- Acharya, T., Tringali, S., Singh, M., & Huang, J.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Huang, Jian
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2014-09-19
- Volume
- 16
- Issue
- 10
- Pages
- 741-745
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC8031950
- OpenAlex
- W1967246062
- Cited by
- 38
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 1 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 4
- FWCI
- 2.29
- 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 › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- resistant hypertension, prevalence, comorbidities, veterans, coronary artery disease, cerebrovascular disease, peripheral vascular disease, congestive heart failure, chronic kidney disease, diabetes mellitus, erectile dysfunction, metabolic syndrome, cardiovascular risk, Framingham risk score, body mass index
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Antihypertensive Agents, California, Cardiovascular Diseases, Cross-Sectional Studies, Drug Resistance, Female, Humans, Hypertension, Male, Middle Aged, Risk Factors, Statistics as Topic, Veterans, Comorbidity, Body Mass Index, Multivariate Analysis, Logistic Models
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