title: Prevalence and clinical characteristics of patients with true resistant hypertension in central and Eastern Europe: data from the BP-CARE study.
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.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Gianmaria
authors.initials: G
authors.lastname: Brambilla
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Gino
authors.initials: G
authors.lastname: Seravalle
authors.forename: Renata
authors.initials: R
authors.lastname: Cifkova
authors.forename: Stephane
authors.initials: S
authors.lastname: Laurent
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Josep
authors.initials: J
authors.lastname: Redon
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D015995:Prevalence; D051437:Renal Insufficiency / Q000150:complications; D012307:Risk Factors; D016896:Treatment Outcome; D059466:White Coat Hypertension / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents