title: [Underestimated frequency of resistant hypertension in predialysis nondiabetic patients].
abstract: The real prevalence of resistant hypertension (RH) is unknown. Studies suggest that it affects 10%-15% of patients treated for hypertension by primary care physicians. RH is defined as blood pressure (BP) remaining above the goal despite the use of optimal doses of 3 or more medicines of different classes (including a diuretic). It means BP >140/90 mm Hg for the general population and >130/80 mm Hg for patients with diabetes or kidney disease. Prior to diagnosing a patient as having RH, it is important to document medication compliance and exclude white-coat hypertension, inaccurate BP measurement, and secondary causes. The role of aldosterone in RH has gained increasing recognition. There is strong evidence for the use of spironolactone as a highly effective antihypertensive agent. Aldosterone plays a significant role in RH pathogenesis, primarily due to its vasoconstrictive effects and the possibility of altering vascular compliance. In RH, there is a high prevalence of cardiac and extra-cardiac target organ damage. It is known that BP control in chronic kidney disease is the key factor for reducing cardiovascular risk and renal disease progression. The objective of the study was to evaluate the prevalence of RH in predialysis nondiabetic (CKD stage I-IV) patients.
authors: Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia. ingrid.prkacin@gmail.com
authors: Ingrid
authors: I
authors: Prkacin
authors: Diana
authors: D
authors: Balenović
authors: Petra
authors: P
authors: Prkacin
authors: Andrija
authors: A
authors: Jurina
authors: Lovro
authors: L
authors: Santek
authors: Dino
authors: D
authors: Kasumović
authors: Gordana
authors: G
authors: Cavrić
authors: Tomislav
authors: T
authors: Bulum
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents