The Prevalence and Prognosis of Resistant Hypertension in Patients with Heart Failure
Open accessAbstract
BACKGROUND: Resistant hypertension is associated with adverse clinical outcome in hypertensive patients. However, the prognostic significance of resistant hypertension in patients with heart failure remains uncertain. METHODS AND RESULTS: The 1 year survival and heart failure re-hospitalization rate of 1288 consecutive patients admitted to a university hospital for either newly diagnosed heart failure or an exacerbation of prior chronic heart failure was analyzed. Resistant hypertension was defined as uncontrolled blood pressure (> 140/90 mmHg) despite being compliant with an antihypertensive regimen that includes 3 or more drugs (including a diuretic). A total of 176 (13.7%) heart failure patients had resistant hypertension. There was no difference in all cause mortality, cardiovascular mortality, and heart failure related re-hospitalization between patients with versus without resistant hypertension. Diabetes [hazard ratio = 1.62, 95% confidence interval = 1.13-2.34; P = 0.010] and serum sodium > 139 mmol/L (hazard ratio = 1.54, 95% confidence interval = 1.06-2.23; P = 0.024) were independently associated with resistant hypertension. Patients with resistant hypertension had a relatively higher survival rate (86.9% vs. 83.8%), although the difference was not significant (log-rank x2 = 1.00, P = 0.317). In patients with reduced ejection fraction, heart failure related re-hospitalization was significantly lower in patients with resistant hypertension (45.8% vs. 59.1%, P = 0.050). CONCLUSIONS: Resistant hypertension appears to be not associated with adverse clinical outcome in patients with heart failure, in fact may be a protective factor for reduced heart failure related re-hospitalization in patients with reduced ejection fraction.
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Resistant hypertension is not associated with increased adverse clinical events in patients with heart failure with reduced ejection fraction and may lower the risk for heart failure-related rehospitalization.
“Conversely, RH is not associated with increased adverse clinical events in patients with heart failure with reduced ejection fraction and may lower the risk for heart failure-related rehospitalization.36”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [36]
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- Authors
- Jin, C.-N., Liu, M., Sun, J.-P., Fang, F., Wen, Y.-N., Yu, C.-M., & Lee, A. P.-W.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Lee, Alex Pui-Wai
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-12-09
- Volume
- 9
- Issue
- 12
- Pages
- e114958
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4260939
- OpenAlex
- W2003863573
- Cited by
- 29
- References
- 49
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 8 · 2022: 3 · 2021: 3 · 2020: 4 · 2018: 4 · 2015: 1
- FWCI
- 0.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- resistant hypertension, heart failure, prognosis, all-cause mortality, cardiovascular mortality, diabetes mellitus, serum sodium, reduced ejection fraction, antihypertensive therapy, survival
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antihypertensive Agents, Blood Pressure, China, Female, Follow-Up Studies, Heart Failure, Heart Rate, Hospitalization, Humans, Hypertension, Male, Middle Aged, Prognosis, Prospective Studies, Stroke Volume, Prevalence, Survival Rate
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