title: [Prevalence of true resistant hypertension among uncontrolled hypertensive patients referred to a tertiary health care center].
abstract: OBJECTIVE
  Estimate the prevalence of resistant hypertension (rHTN) in uncontrolled hypertensive treated patients referred to a tertiary care center specialized for hypertension management.
  
  
  METHODS
  The study was prospective observational. Between January 2013 and April 2015, we recruited hypertensive treated patients, 18years age or older, under antihypertensive drugs since at least 12months, and referred to the hypertension unit of Tizi-ouzou university hospital for uncontrolled hypertension. rHTn was defined as an office blood pressure≥140mmHg despite a triple therapy including renin angiotensin system blockers, calcium antagonists and diuretics at optimal doses, since at least 4weeks.
  
  
  RESULTS
  We screened 2367 patients with a mean age of 61.1±11.2years and 64.2% of men. Eight hundred forty-three (35.6%) patients had suboptimal treatment, 364 (15.4%) a poor adherence to treatment and 202 (8.5%) a white-coat effect. An excessive salt intake and a drug-related hypertension were identified in 281 (11.9%) and 36 (1.5%) patients, respectively. A secondary cause of hypertension was diagnosed in 468 (19.8%) subjects. Finally, only 173 patients showed a true rHTN requiring four drugs or more and its prevalence was 7.3% (CI 95%: 6.3-8.3).
  
  
  CONCLUSIONS
  Less than one patient from ten referred in our center for uncontrolled hypertension had a true rHTN, and more than fifty percent of patients had pseudo-resistance. Most of patients with seemingly rHTN can reach blood pressure target provided they undergo thorough work up and care by a specialized team.
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie. Electronic address: nr.henine@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Henine
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie.
authors.forename: B
authors.initials: B
authors.lastname: Kichou
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie.
authors.forename: L
authors.initials: L
authors.lastname: Kichou
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie.
authors.forename: M
authors.initials: M
authors.lastname: Benbouabdellah
authors.affiliation: Service de néphrologie, centre hospitalier universitaire de Tizi-ouzou, 15000 Tizi-ouzou, Algérie.
authors.forename: M A
authors.initials: MA
authors.lastname: Boubchir
authors.affiliation: Service de néphrologie, centre hospitalier universitaire de Tizi-ouzou, 15000 Tizi-ouzou, Algérie.
authors.forename: A
authors.initials: A
authors.lastname: Madiou
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie.
authors.forename: A
authors.initials: A
authors.lastname: Hammouche
authors.affiliation: Service de cardiologie, centre hospitalier universitaire de Tizi-ouzou, 9, rue Lamali Ahmed, 15000 Tizi-ouzou, Algérie.
authors.forename: B
authors.initials: B
authors.lastname: Saheb
mesh_terms: D000368:Aged; D000462:Algeria / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics
keywords: Effet blouse blanche; HTA non contrôlée; HTA résistante; Non-adherence to treatment; Non-observance du traitement; Optimal antihypertensive treatment; Resistant hypertension; Traitement antihypertenseur optimal; Uncontrolled hypertension; White-coat effect