title: [Prevalence of target organ damage and metabolic abnormalities in resistant hypertension].
abstract: OBJECTIVE
  Patients with resistant hypertension (RH) are relatively frequently visited in specialized units of hypertension. The aim of this study was to assess the prevalence of target organ damage, central obesity and metabolic syndrome in a cohort of patients with RH consecutively included in the Register of Resistant Hypertension of the Spanish Society of Hypertension (SHE-LELHA).
  
  
  METHODS
  Cross-sectional, multicenter epidemiologic study in usual clinical practice conditions. Patients with clinical diagnosis of resistant hypertension, that is, office systolic and diastolic blood pressure ≥ 140 mm Hg and/or ≥ 90 mm Hg, respectively, despite a prescribed therapeutic schedule with an appropriate combination of three or more full-dose antihypertensive drugs, including a diuretic, were consecutively recruited from specialized hypertension units spread through Spain. Demographic and anthropometric characteristics as well as cardiovascular risk factors and associated conditions were recorded, and all the subjects underwent 24-h ambulatory blood pressure monitoring. Left ventricular hypertrophy was considered as a left ventricular mass index ≥ 125 g/m(2) in males and ≥ 110 g/m(2) in females. Left atrial enlargement was defined as an indexed left atrium diameter ≥ 26 mm/m(2). Microalbuminuria was defined as a urinary albumin/creatinine ratio ≥ 22 mg/g in males and ≥ 31 mg/g in females.
  
  
  RESULTS
  513 patients were included, aged 64±11 years old, 47% women. Central obesity was present in 65.7% (CI 95% 61.6-69.9), 38.6% (CI 95% 34.4-42.8) had diabetes and 63.7% (CI 95% 59.4-67.9) had metabolic syndrome. The prevalence of left ventricular hypertrophy and left atrial enlargement, determined by echocardiography was 57.1% (CI 95% 50.8-63.5) and 10.0% (CI 95% 6.3-13.7) respectively. Microalbuminuria was found in 46.6% (CI 95% 41.4-51.8) of the subjects. Patients with metabolic syndrome were significantly older (65.4±11 and 62.5±12 years; P=.0052), presented a higher prevalence of diabetes (52.0% vs. 16.6; P<.0001) and were treated more frequently with ≥ 4 antihypertensive drugs (65.1 vs. 50.0%, P=.011).
  
  
  CONCLUSIONS
  The prevalence of central obesity, metabolic syndrome and target organ damage is very high in resistant hypertensive subjects.
authors: Unidad de Hipertensión Arterial, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Universidad de Barcelona, Barcelona, Spain. parmariog@gmail.com
authors: Pedro
authors: P
authors: Armario
authors: Anna
authors: A
authors: Oliveras
authors: Raquel
authors: R
authors: Hernández Del Rey
authors: Luis Miguel
authors: LM
authors: Ruilope
authors: Alejandro
authors: A
authors: De La Sierra
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004351:Drug Resistance; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology*; D058958:Organs at Risk / Q000473:pathology; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents