Clinical characteristics of resistant hypertension evaluated by ambulatory blood pressure monitoring
Abstract
Strict control of blood pressure is important to prevent cardiovascular disease, although it is sometimes difficult to decrease blood pressure to target levels. The aim of this study was to investigate the clinical characteristics of resistant hypertension evaluated by ambulatory blood pressure monitoring. One hundred in-hospital patients, whose 24-hour average blood pressure was higher than 130/80 mmHg even after treatment with more than three antihypertensive drugs, were included in the present analysis. Circadian variation of blood pressure was evaluated by nocturnal fall in systolic blood pressure. Average blood pressures of all patients were high in both daytime and nighttime, 150.0/82.9 and 143.8/78.2 mmHg, respectively. Twenty patients had been treated with hemodialysis or peritoneal dialysis. In 63 patients out of the other 80 patients (79%), estimated glomerular filtration rate (eGFR) was also decreased (<60 mL/min/1.73 m²). The patients classified into dipper, non-dipper, riser and extreme-dipper were 20%, 43%, 34% and 3%, respectively. In addition, in 17 patients whose eGFR was preserved, 12 patients showed a non-dipper or riser pattern, suggesting that it was difficult to account for this altered circadian blood pressure variation only by renal dysfunction. These results show that a large number of the patients with resistant hypertension suffered from renal dysfunction, although it was difficult to explain altered circadian blood pressure variation based on renal dysfunction alone.
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The normal nocturnal decline in blood pressure is attenuated in a high proportion (43%-65%) of individuals with resistant hypertension.
“The normal nocturnal decline in BP is also attenuated in a high proportion (43%−65%) of individuals with RH.32,53,54”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [54]
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- Authors
- Kansui, Y., Matsumura, K., Kida, H., Sakata, S., Ohtsubo, T., Ibaraki, A., & Kitazono, T.
- Affiliations
- Kyushu University (JP)
- Corresponding author
- Matsumura, Kiyoshi
- Venue
- Clinical and Experimental Hypertension
- Publisher
- Informa UK Limited
- Published
- 2013-10-28
- Volume
- 36
- Issue
- 7
- Pages
- 454-458
- ISSN
- 0148-3927 (ISSN-L)
- 1064-1963
- 1525-6006
- OpenAlex
- W2084167278
- Cited by
- 8
- References
- 30
- Citations by year
- 2026: 1 · 2023: 1 · 2020: 2 · 2018: 2 · 2016: 2
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical and Experimental 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, ambulatory blood pressure monitoring, circadian blood pressure variation, non-dipper pattern, nocturnal blood pressure dipping, estimated glomerular filtration rate, renal dysfunction, hemodialysis, peritoneal dialysis, antihypertensive therapy, cardiovascular risk
- MeSH terms
- Antihypertensive Agents, Circadian Rhythm, Drug Resistance, Female, Renal Dialysis, Humans, Hypertension, Kidney, Kidney Failure, Chronic, Male, Middle Aged, Blood Pressure Monitoring, Ambulatory
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