Treatment efficiency of resistant hypertension in cardiologist's office.
BACKGROUND
The target values of blood pressure have not been achieved in our population of patients sufficiently. The most difficult is a control of patients with resistant hypertension. We do not have data about efficiency treatment of these patients today.


OBJECTIVE
The aim of our study was to assess current treatment status and by antihypertensive treatment modification we tried to reach an adequate blood pressure control.


METHODS
Fifty two patients suffering from resistant hypertension 2-3 degree ESC/ESH with high cardiovascular risk have been observed. Reaching of the target blood pressure values was verified by 24-hour ambulatory blood pressure monitoring.


RESULTS
The target blood pressure values were achieved in 50 % of patients during 18 months. We noticed a statistically significant difference (p<0.001) in a decrease of casual and 24-hour ambulatory blood pressure in the group of controlled hypertensive patients in comparison with a group where blood pressure did not decrease sufficiently. In case of 50 % patients, the target blood pressure values have not been reached in spite of more antihypertensive drugs and a higher dose.


CONCLUSIONS
Adequately and systematically controlled patients were treated less intensively in comparison with an inadequately controlled group. 24-hour blood pressure monitoring analysis confirmed correction of the patological diurnal rhythm mostly in adequate blood pressure controlled group. In this group, we have noticed a statistically significant decrease of blood urea and creatinin levels and albumin/creatinin ratio in urine. Resistant hypertension needs multi-faceted approach with consistent control of all comorbidities in a case of problematic blood pressure control (Tab. 6, Fig. 1, Ref. 21).
A
A
Dlesk
G
G
Kamensky
M
M
Stefanik
M
M
Kuzma
M
M
Pernicky
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D002940:Circadian Rhythm; D015897:Comorbidity; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics