Cited by 32Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionHormonal Regulation and Hypertension

Blood Pressure Control Provides Less Cardiovascular Protection in Adults With Than Without Apparent Treatment‐Resistant Hypertension

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Egan, Brent M., Kai, Bo, Wagner, C. Shaun, Henderson, Joseph H., Chandler, Archie H., Sinopoli, Angelo·2016·The Journal of Clinical Hypertension

Abstract

Hypertension control may offer less protection from incident cardiovascular disease (CVDi) in adults with than without apparent treatment‐resistant hypertension (aTRH), ie, blood pressure uncontrolled while taking three or more antihypertensive medications or controlled to <140/<90 mm Hg while taking four or more antihypertensive medications. Electronic health data were matched to health claims for 2006–2012. Patients with CVDi in 2006–2007 or with untreated hypertension were excluded, leaving 118,356 treated hypertensives, including 40,690 with aTRH, and 460,599 observation years. Blood pressure and medication number were determined by all clinic visit means from 2008 to CVDi or end of study. Primary outcome was first CVDi (stroke, coronary heart disease, heart failure) from hospital and emergency department claims. Controlling for age, race, sex, diabetes, chronic kidney disease, and statin use, hypertension control afforded less CVDi protection in patients with aTRH (hazard ratio, 0.87; 95% confidence interval, 0.82–0.93) than without aTRH (hazard ratio, 0.69; 95% confidence interval, 0.65–0.74; P<.001). Strategies beyond hypertension control may prevent more CVDi in patients with aTRH.

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  1. [22]Breslow NE Day NE Modelling the relationship between risk, dose, and time International Agency for Research on Cancer. Statistical Method in Cancer Research: The Design and Analysis of Cohort Data Lyon, France Oxford University Press 1987 232 70
  2. [23]Greenland S Applications of Stratified Analysis Methods Modern Epidemiology 3 Rothman KJ Greenland S Lash TL Philadelphia, USA Lippincott Williams & Wilkins 2008 283 302

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Authors
Egan, B. M., Kai, B., Wagner, C. S., Henderson, J. H., Chandler, A. H., & Sinopoli, A.
Affiliations
  • Prisma Health (US)
  • College of Charleston (US)
  • University of South Carolina (US)
Corresponding author
Egan, Brent M.
Venue
The Journal of Clinical Hypertension
Publisher
Wiley
Published
2016-02-09
Volume
18
Issue
8
Pages
817-824
ISSN
  • 1524-6175 (ISSN-L)
  • 1751-7176
OpenAlex
W2253820963
Cited by
32
References
46
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 1
FWCI
3.02
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Hypertension (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Medtronic
  • National Institutes of Health (HL105880)
  • Centers for Disease Control and Prevention
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 › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
treatment-resistant hypertension, blood pressure control, cardiovascular disease incidence, antihypertensive medication burden, cardioprotection, stroke, coronary artery disease, heart failure, hypertension
MeSH terms
Adult, Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Cardiovascular Diseases, Emergency Medical Services, Female, Humans, Hypertension, Male, Middle Aged, Risk Factors, Prevalence, Treatment Failure

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