title: Resistant hypertension and associated comorbidities in a veterans affairs population.
abstract: Resistant hypertension (RH) is understudied and its reported prevalence varies with study populations. The authors sought to determine its prevalence and association with certain comorbid conditions in a Veterans Affairs population. This cross-sectional study utilized demographic and clinical data from 17,466 patients. Chi-square or t test was used for comparing groups with and without RH. Multivariate logistic regression analysis was used to determine independent associations. Overall, the prevalence of RH was 9%, and 13% of all hypertensive patients met criteria for RH. After adjusting for confounding variables, RH was significantly associated with older age (odds ratio [OR], 1.007), higher body mass index (OR, 1.04), Framingham score (OR, 1.14), and coexisting coronary artery disease, cerebrovascular accident/transient ischemic attack, peripheral vascular disease, congestive heart failure, chronic kidney disease, diabetes mellitus, erectile dysfunction, and metabolic syndrome (OR, 1.3, 1.32, 1.29, 2.88, 2.13, 1.2, 1.12, and 1.2, respectively; all P<.05). Our results indicate a complex interplay of certain comorbid conditions among patients with RH and suggest the need for multifaceted interventions in this high-risk population to prevent cardiovascular events.
authors.affiliation: Primary Care Service, VA Central California Health Care System, Fresno, CA; Department of Medicine, University of California San Francisco-Fresno Medical Education Program, Fresno, CA.
authors.forename: Tushar
authors.initials: T
authors.lastname: Acharya
authors.forename: Steven
authors.initials: S
authors.lastname: Tringali
authors.forename: Manmeet
authors.initials: M
authors.lastname: Singh
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D002140:California; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013223:Statistics as Topic; D014728:Veterans
chemical_list: D000959:Antihypertensive Agents