title: Low Blood Pressure Is Associated With Greater Risk for Cardiovascular Events in Treated Adults With and Without Apparent Treatment-Resistant Hypertension.
abstract: Apparent treatment-resistant hypertension (aTRH) may confound the reported relationship between low blood pressure (BP) and increased cardiovascular disease (CVD) in treated hypertensive patients. Incident CVD was assessed in treated hypertensive patients with and without aTRH (BP ≥140 and/or ≥90 mm Hg on ≥3 medications or <140/<90 mm Hg on ≥4 BP medications) at three BP levels: 1: <120 and/or <70 mm Hg and <140/<90 mm Hg; 2: 120-139/70-89 mm Hg; and 3: ≥140 and/or ≥90 mm Hg. Electronic health data were matched to emergency and hospital claims for incident CVD in 118 356 treated hypertensive patients. In adults with and without aTRH, respectively, CVD was greater in level 1 versus level 2 (multivariable hazard ratio, 1.88 [95% confidence interval [CI], 1.70-2.07]; 1.71 [95% CI, 1.59-1.84]), intermediate in level 1 versus level 3 (hazard ratio, 1.32 [95% CI, 1.21-1.44]; 0.99, [95% CI, 0.92-1.07]), and lowest in level 2 versus level 3 (hazard ratio, 0.70 [95% CI, 0.65-0.76]; 0.58, [95% CI, 0.54-0.62]). Low treated BP was associated with more CVD than less stringent BP control irrespective of aTRH.
authors: Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA.|Care Coordination Institute, Greenville Health System, Greenville, SC, USA.
authors: Brent M
authors: BM
authors: Egan
authors: Department of Mathematics, College of Charleston, Charleston, SC, USA.
authors: Bo
authors: B
authors: Kai
authors: Care Coordination Institute, Greenville Health System, Greenville, SC, USA.
authors: C Shaun
authors: CS
authors: Wagner
authors: Care Coordination Institute, Greenville Health System, Greenville, SC, USA.
authors: Douglas O
authors: DO
authors: Fleming
authors: Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA.
authors: Joseph H
authors: JH
authors: Henderson
authors: Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA.
authors: Archie H
authors: AH
authors: Chandler
authors: Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA.|Care Coordination Institute, Greenville Health System, Greenville, SC, USA.
authors: Angelo
authors: A
authors: Sinopoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004351:Drug Resistance / Q000502:physiology*; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007022:Hypotension / Q000150:complications*; D008297:Male; D008875:Middle Aged