title: Resistant hypertension: do all definitions describe the same patients?
abstract: Resistant hypertension (RH) is defined as blood pressure (BP) that remains ⩾140 and/or 90 mm Hg despite therapy with ⩾3 full-dose antihypertensive drugs (classical definition=CD). A definition proposed subsequently (new definition=ND) includes patients requiring ⩾4 drugs irrespective of BP values. We aimed to evaluate whether both definitions characterize the same kind of patients.One hundred and twenty-four consecutively attended patients with RH were classified into two groups according to their BP control: 66 patients had non-controlled BP (all those who met the CD criteria plus a few patients who met the ND criteria); 58 patients had controlled BP (all with RH according to the ND). Clinical, laboratory and office BP data were recorded. RH patients with non-controlled BP were more frequently diabetic (72% vs 49%), and had higher plasmatic glucose (149 vs 130 mg dl(-1)), cholesterol (179 vs 164 mg dl(-1)), low-density lipoprotein (LDL)-cholesterol (107 vs 95 mg dl(-1)) and triglyceride (169 vs 137 mg dl(-1)) levels; P<0.05 for all comparisons. In multivariate logistic regression analysis, the variables that independently associated with non-controlled BP were diabetes (P=0.001) and higher LDL-cholesterol (P=0.007).We conclude that, although both cohorts of patients are phenotypically quite similar, uncontrolled RH patients have higher prevalence of diabetes mellitus and higher LDL-cholesterol levels than controlled RH patients.
authors.affiliation: Faculty of Health and Life Sciences, Universitat Autònoma de Barcelona - Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Boswell
authors.affiliation: 1] Faculty of Health and Life Sciences, Universitat Autònoma de Barcelona - Universitat Pompeu Fabra, Barcelona, Spain [2] Nephrology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pascual
authors.affiliation: 1] Faculty of Health and Life Sciences, Universitat Autònoma de Barcelona - Universitat Pompeu Fabra, Barcelona, Spain [2] Nephrology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Oliveras
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010641:Phenotype; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D009626:Terminology as Topic; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids