title: The prevalence and prognosis of resistant hypertension in patients with heart failure.
abstract: BACKGROUND
  Resistant hypertension is associated with adverse clinical outcome in hypertensive patients. However, the prognostic significance of resistant hypertension in patients with heart failure remains uncertain.
  
  
  RESULTS
  The 1 year survival and heart failure re-hospitalization rate of 1288 consecutive patients admitted to a university hospital for either newly diagnosed heart failure or an exacerbation of prior chronic heart failure was analyzed. Resistant hypertension was defined as uncontrolled blood pressure (> 140/90 mmHg) despite being compliant with an antihypertensive regimen that includes 3 or more drugs (including a diuretic). A total of 176 (13.7%) heart failure patients had resistant hypertension. There was no difference in all cause mortality, cardiovascular mortality, and heart failure related re-hospitalization between patients with versus without resistant hypertension. Diabetes [hazard ratio = 1.62, 95% confidence interval = 1.13-2.34; P = 0.010] and serum sodium > 139 mmol/L (hazard ratio = 1.54, 95% confidence interval = 1.06-2.23; P = 0.024) were independently associated with resistant hypertension. Patients with resistant hypertension had a relatively higher survival rate (86.9% vs. 83.8%), although the difference was not significant (log-rank x2 = 1.00, P = 0.317). In patients with reduced ejection fraction, heart failure related re-hospitalization was significantly lower in patients with resistant hypertension (45.8% vs. 59.1%, P = 0.050).
  
  
  CONCLUSIONS
  Resistant hypertension appears to be not associated with adverse clinical outcome in patients with heart failure, in fact may be a protective factor for reduced heart failure related re-hospitalization in patients with reduced ejection fraction.
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Chun-Na
authors.initials: CN
authors.lastname: Jin
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Sun
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Yong-Na
authors.initials: YN
authors.lastname: Wen
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.affiliation: Division of Cardiology, Li Ka Shing Institute of Health Sciences, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Alex Pui-Wai
authors.initials: AP
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D015996:Survival Rate
chemical_list: D000959:Antihypertensive Agents