Cristiano Macedo1, Roque Aras Junior1, Isabella Sales de Macedo2. 1. Hospital Universitário Professor Edgard Santos - Cardiologia, Salvador- BA - Brasil. 2. Universidade de São Paulo - Faculdade de Medicina, São Paulo, SP - Brasil.
Abstract
BACKGROUND: Afrodescendants have been associated with a greater severity of arterial hypertension and a higher incidence of cardiovascular complications. Characteristics in the presentation of resistant hypertension (RH) or refractory hypertension (RfH), specifically in this ethnic group, have not been properly studied. OBJECTIVES: The study compares clinical and epidemiological characteristics and prevalence of cardiovascular events in people of African descent diagnosed with RH or RfH. METHODS: Cross-sectional study carried out in a referral clinic for patients with severe hypertension. The level of significance was 5%. RESULTS: 146 consecutive patients were evaluated, of which 68.7% were female. The average age was 61.8 years, with 88.4% of Afrodescendants (mixed race or black). 51% had RfH. There was a high prevalence of cardiovascular risk factors: 34.2% of subjects had diabetes, 69.4% dyslipidemia, 36.1% obesity, and 38.3% history of smoking. Reduced renal function was seen in 34.2%. Previous cardiovascular events occurred in 21.8% for myocardial infarction and in 19.9% for stroke. The Framingham's risk score was moderate/high at 61%. RfH patients were younger (mean age 59.38±11.69 years versus 64.10±12.23 years, p=0.02), had more dyslipidemia (83.8 versus 66.7%, p=0.021), and stroke (30.4 versus 12.3%, p=0.011) when compared to those with RH. The use of a combination of ACEi/ARB+CCB+Diuretic, chlortalidone and spironolactone was also more frequent in individuals with RfH. CONCLUSION: Africandescendant people with RH had a high cardiovascular risk, a high prevalence of RfH, a higher frequency of dyslipidemia and stroke, compatible with a high incidence of injury to target organs. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
BACKGROUND: Afrodescendants have been associated with a greater severity of arterial hypertension and a higher incidence of cardiovascular complications. Characteristics in the presentation of resistant hypertension (RH) or refractory hypertension (RfH), specifically in this ethnic group, have not been properly studied. OBJECTIVES: The study compares clinical and epidemiological characteristics and prevalence of cardiovascular events in people of African descent diagnosed with RH or RfH. METHODS: Cross-sectional study carried out in a referral clinic for patients with severe hypertension. The level of significance was 5%. RESULTS: 146 consecutive patients were evaluated, of which 68.7% were female. The average age was 61.8 years, with 88.4% of Afrodescendants (mixed race or black). 51% had RfH. There was a high prevalence of cardiovascular risk factors: 34.2% of subjects had diabetes, 69.4% dyslipidemia, 36.1% obesity, and 38.3% history of smoking. Reduced renal function was seen in 34.2%. Previous cardiovascular events occurred in 21.8% for myocardial infarction and in 19.9% for stroke. The Framingham's risk score was moderate/high at 61%. RfH patients were younger (mean age 59.38±11.69 years versus 64.10±12.23 years, p=0.02), had more dyslipidemia (83.8 versus 66.7%, p=0.021), and stroke (30.4 versus 12.3%, p=0.011) when compared to those with RH. The use of a combination of ACEi/ARB+CCB+Diuretic, chlortalidone and spironolactone was also more frequent in individuals with RfH. CONCLUSION: Africandescendant people with RH had a high cardiovascular risk, a high prevalence of RfH, a higher frequency of dyslipidemia and stroke, compatible with a high incidence of injury to target organs. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
Authors: Thayza de Paula Araújo; Lucas Gabriel Sulino Borges; Weimar Kunz Sebba Barroso; Andrea Araújo Brandão; Eduardo Costa Duarte Barbosa; Audes Diógenes M Feitosa; Marcus Vinícius Bolivar Malachias; Marco Mota Gomes; Celso Amodeo; Rui Manoel Dos Santos Povoa; Paulo César Brandão Veiga Jardim; Renato D Lopes; Sandro Rogério Rodrigues Batista; Priscila Valverde de Oliveira Vitorino Journal: J Clin Hypertens (Greenwich) Date: 2022-06-30 Impact factor: 2.885