title: Improvement in All-Cause Mortality With Blood Pressure Control in a Group of US Veterans With Drug-Resistant Hypertension.
abstract: The current definition of drug-resistant hypertension includes patients with uncontrolled (URH) (taking ≥3 antihypertensive medications) and controlled hypertension (CRH; blood pressure [BP] ≤140/90 mm Hg) (taking ≥4 medications). The authors hypothesized that all-cause mortality is reduced when URH is controlled. Qualified patients followed at the Washington DC VA Medical Center were included. BPs were averaged for each year of follow-up. In 2006, among 2906 patients who met the criteria for drug-resistant hypertension, 628 had URH. During follow-up, 234 patients were controlled (group 1) and 394 patients remained uncontrolled (group 2). The mortality rate among patients with URH was 28% (110 of 394) and among patients with CRH was 13% (30 of 234), a 54% reduction (P<.01). Multivariate analysis identified independent predictors of mortality as uncontrolled HTN (hazard ratio, 2.5; 95% confidence interval, 1.67-3.75; P<.01), age (hazard ratio, 1.03; 95% confidence interval, 1.01-1.04; P<.01), and diabetes (hazard ratio, 1.46; 95% confidence interval, 1.04-2.05; P<.027). The authors conclude that controlling drug-resistant hypertension markedly reduces all-cause mortality.
authors.affiliation: George Washington University Hospital, Washington, DC.|Georgetown University Hospital, Washington, DC.|Veterans Affairs Medical Center, Washington, DC.|Washington Hospital Center, Washington, DC.
authors.forename: Omid
authors.initials: O
authors.lastname: Fatemi
authors.affiliation: Georgetown University Hospital, Washington, DC.|Veterans Affairs Medical Center, Washington, DC.|Washington Hospital Center, Washington, DC.
authors.forename: Cristobal
authors.initials: C
authors.lastname: Goa
authors.affiliation: Veterans Affairs Medical Center, Washington, DC.|George Washington University School of Medicine, Washington, DC.
authors.forename: Charles
authors.initials: C
authors.lastname: Faselis
authors.affiliation: Veterans Affairs Medical Center, Washington, DC.|George Washington University School of Medicine, Washington, DC.|Georgetown University School of Medicine, Washington, DC.
authors.forename: Peter
authors.initials: P
authors.lastname: Kokkinos
authors.affiliation: Georgetown University Hospital, Washington, DC.|Washington DC VA Medical Center, Washington, DC.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papademetriou
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents