title: Predictors of resistant hypertension in an unselected sample of an adult male population in Italy.
abstract: Prevalence, incidence and predictors of resistant hypertension (RH), (defined as blood pressure persistently above goal in spite of the concurrent use of three antihypertensive agents of different classes) in the general population remain largely unknown. A complete database including anthropometric and biochemical data was collected in 1994-1995 (baseline examination) in 1,019 participants (mean age 51.8, range: 25-79 years) and again in 2002-2004 in 794 male participants of the Olivetti Heart Study (OHS) in southern Italy. The incidence of RH over the average follow-up time of 7.9 years was 4.8% (38/794) in the whole study population and 10.1% (31/307) among hypertensive participants. Basal blood pressure (systolic, diastolic or pulse pressure), cholesterol and urinary albumin/creatinine ratio (ACR) significantly predicted the risk of developing RH using a logistic regression model that also included age as covariates. If in the same model we added basal pharmacological treatment, the fractional excretion of sodium (FENa) also became a statistically significant predictor, and this last model explained nearly 25% of the risk of developing RH. In this unselected sample of an adult male population, ACR (an early marker of organ damage), an elevated FENa (a proxy for dietary sodium intake), cholesterol and a higher basal blood pressure level were independent predictors of RH.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University of Naples Medical School, Via S. Pansini, 5, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Barbato
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Galletti
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacone
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.forename: Renato
authors.initials: R
authors.lastname: Ippolito
authors.forename: Antonella
authors.initials: A
authors.lastname: Venezia
authors.forename: Eduardo
authors.initials: E
authors.lastname: Farinaro
authors.forename: Pasquale
authors.initials: P
authors.lastname: Strazzullo
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012982:Sodium, Dietary; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents; D012982:Sodium, Dietary