Gianmaria Brambilla1, Michele Bombelli, Gino Seravalle, Renata Cifkova, Stephane Laurent, Krzysztof Narkiewicz, Rita Facchetti, Josep Redon, Giuseppe Mancia, Guido Grassi. 1. aClinica Medica, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza bIstituto Auxologico Italiano, Ospedale San Luca, Milan, Italy cCenter for Cardiovascular Prevention, Thomayer Hospital and Department of Preventive Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic dPharmacology Department and INSERM U970 Hopital Europeen Georges Pompidou, Assistance-Publique Hopitaux de Paris, Paris-Derscartes University, France eDepartment of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland fInternal Medicine, Hospital Clinico, University of Valencia, Valencia, Spain gIRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
Abstract
OBJECTIVE: Scanty information is available on the clinical characteristics of resistant hypertension in Central and East European countries. The Blood Pressure (BP) control rate and CArdiovascular Risk profilE (BP-CARE) study allowed us to assess the prevalence and the main clinical features of resistant hypertension in this population. DESIGN AND METHOD: The study was carried out in 1312 treated hypertensive patients living in nine Central and East European countries. RESULTS: Four hundred and twenty-three patients had apparent resistant hypertension, of whom 168 had pseudo-resistant hypertension (noncompliant/white-coat) and 255 were true treatment-resistant hypertension patients (TRH). Clinical BP values in TRH amounted to 157.4±16.9/91.8±10.0 mmHg despite the daily use of 3.6±0.7 drugs. Their 24-h BP values were 149.5±16.5/97.5±9.8 mmHg. Compared to controlled hypertensive patients (n=368) and uncontrolled nonresistant hypertensive patients (n=521), TRH were older with a greater prevalence of women. They showed a higher rate of previous cardiovascular events and a very high cardiovascular risk profile. Estimated glomerular filtration rate was significantly lower in TRH as compared to controlled hypertensive patients and uncontrolled nonresistant hypertensive patients. Overall, target organ damage was more frequently detected in TRH than in controlled hypertensive patients and uncontrolled nonresistant hypertensive patients. The factor most frequently associated with TRH was severity of hypertension followed by age, total cholesterol, BMI and history of heart failure. CONCLUSIONS: The present study provides evidence that the prevalence of TRH in Central and East European countries is similar to that found in Western Europe and USA. It also shows the very high cardiovascular risk of TRH and the elevated association of this condition with obesity, renal failure, organ damage and history of cardiovascular events.
OBJECTIVE: Scanty information is available on the clinical characteristics of resistant hypertension in Central and East European countries. The Blood Pressure (BP) control rate and CArdiovascular Risk profilE (BP-CARE) study allowed us to assess the prevalence and the main clinical features of resistant hypertension in this population. DESIGN AND METHOD: The study was carried out in 1312 treated hypertensivepatients living in nine Central and East European countries. RESULTS: Four hundred and twenty-three patients had apparent resistant hypertension, of whom 168 had pseudo-resistant hypertension (noncompliant/white-coat) and 255 were true treatment-resistant hypertensionpatients (TRH). Clinical BP values in TRH amounted to 157.4±16.9/91.8±10.0 mmHg despite the daily use of 3.6±0.7 drugs. Their 24-h BP values were 149.5±16.5/97.5±9.8 mmHg. Compared to controlled hypertensivepatients (n=368) and uncontrolled nonresistant hypertensivepatients (n=521), TRH were older with a greater prevalence of women. They showed a higher rate of previous cardiovascular events and a very high cardiovascular risk profile. Estimated glomerular filtration rate was significantly lower in TRH as compared to controlled hypertensivepatients and uncontrolled nonresistant hypertensivepatients. Overall, target organ damage was more frequently detected in TRH than in controlled hypertensivepatients and uncontrolled nonresistant hypertensivepatients. The factor most frequently associated with TRH was severity of hypertension followed by age, total cholesterol, BMI and history of heart failure. CONCLUSIONS: The present study provides evidence that the prevalence of TRH in Central and East European countries is similar to that found in Western Europe and USA. It also shows the very high cardiovascular risk of TRH and the elevated association of this condition with obesity, renal failure, organ damage and history of cardiovascular events.
Authors: F Fici; G Seravalle; N Koylan; I Nalbantgil; N Cagla; Y Korkut; F Quarti-Trevano; W Makel; G Grassi Journal: High Blood Press Cardiovasc Prev Date: 2017-05-11
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