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Clinical Features of 8295 Patients With Resistant Hypertension Classified on the Basis of Ambulatory Blood Pressure Monitoring
Abstract
We aimed to estimate the prevalence of resistant hypertension through both office and ambulatory blood pressure monitoring in a large cohort of treated hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. In addition, we also compared clinical features of patients with true or white-coat–resistant hypertension. In December 2009, we identified 68 045 treated patients with complete information for this analysis. Among them, 8295 (12.2% of the database) had resistant hypertension (office blood pressure ≥140 and/or 90 mm Hg while being treated with ≥3 antihypertensive drugs, 1 of them being a diuretic). After ambulatory blood pressure monitoring, 62.5% of patients were classified as true resistant hypertensives, the remaining 37.5% having white-coat resistance. The former group was younger, more frequently men, with a longer duration of hypertension and a worse cardiovascular risk profile. The group included larger proportions of smokers, diabetics, target organ damage (including left ventricular hypertrophy, impaired renal function, and microalbuminuria), and documented cardiovascular disease. Moreover, true resistant hypertensives exhibited in a greater proportion a riser pattern (22% versus 18%; P <0.001). In conclusion, this study first reports the prevalence of resistant hypertension in a large cohort of patients in usual daily practice. Resistant hypertension is present in 12% of the treated hypertensive population, but among them more than one third have normal ambulatory blood pressure. A worse risk profile is associated with true resistant hypertension, but this association is weak, thus making it necessary to assess ambulatory blood pressure monitoring for a correct diagnosis and management.
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“Among treated adults with hypertension, prevalent aTRH occurs in ≈12% to 15% of population-based13–16 and 15% to 18% of clinic-based reports.17–20”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [18]
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Metadata
- Authors
- de la Sierra, A., Segura, J., Banegas, J. R., Gorostidi, M., de la Cruz, J. J., Armario, P., Oliveras, A., & Ruilope, L. M.
- Affiliations
- From the Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona (A.d.l.S.), Hypertension Unit (J.S., L.M.R.), Hospital 12 de Octubre, Madrid, Spain; Department of Preventive Medicine and Public Health (J.R.B., J.J.d.l.C.), Autonomous University, Madrid, Spain; Department of Nephrology (M.G.), Hospital Universitario Central de Asturias, Oviedo, Spain; Department of Internal Medicine (P.A.), Hospital General de L'Hospitalet, Barcelona, Spain; Hypertension Unit (A.O.),...
- Universitat Autònoma de Barcelona (ES)
- Venue
- Hypertension
- Published
- 2011-05
- Volume
- 57
- Issue
- 5
- Pages
- 898-902
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2113750355
- Cited by
- 809
- References
- 32
- Citations by year
- 2026: 14 · 2025: 9 · 2024: 32 · 2023: 33 · 2022: 34 · 2021: 25 · 2020: 35 · 2019: 49 · 2018: 41 · 2017: 48 · 2016: 88 · 2015: 68 · 2014: 115 · 2013: 130 · 2012: 63
- FWCI
- 73.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- 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 › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- resistant hypertension, white coat hypertension, ambulatory blood pressure monitoring, prevalence, cardiovascular risk profile, target organ damage, left ventricular hypertrophy, microalbuminuria, renal dysfunction, cardiovascular disease, duration of hypertension, smoking, diabetes mellitus, antihypertensive therapy
- MeSH terms
- Age Factors, Aged, Antihypertensive Agents, Blood Pressure, Female, Humans, Hypertension, Male, Middle Aged, Registries, Risk, Sex Factors, Smoking, Spain, Prevalence, Chi-Square Distribution, Blood Pressure Monitoring, Ambulatory, Statistics, Nonparametric
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