Resistant Hypertension and Mortality: An Observational Cohort Study

被引：3

作者：

de la Sierra, Alejandro ^{[1
]}

Ruilope, Luis M. ^{[2
]}

Staplin, Natalie ^{[3
]}

Gorostidi, Manuel ^{[4
]}

Vinyoles, Ernest ^{[5
]}

Segura, Julian ^{[2
]}

Armario, Pedro ^{[6
]}

Oliveras, Anna ^{[7
]}

Williams, Bryan ^{[8
]}

机构：

[1] Univ Barcelona, Hosp Mutua Terrassa, Dept Internal Med, Plaza Doctor Robert 5, Terrassa 08221, Spain

[2] Hosp 12 Octubre, Hypertens Unit & Cardiorenal Translat Lab, Madrid, Spain

[3] Univ Oxford, Populat Hlth Res Unit, Nuffield Dept Populat Hlth, Clin Trial Serv Unit & Epidemiol Studies Unit,MRC, Oxford, England

[4] Hosp Univ Cent Asturias, Dept Nephrol, Oviedo, Spain

[5] Univ Barcelona, Inst Univ Invest Atencio Primaria Jordi Gol, Primary Care Ctr La Mina, Barcelona, Spain

[6] Univ Barcelona, Hosp Moises Broggi, Cardiovasc Risk Area, St Joan Despi, Spain

[7] Hosp del Mar, Dept Nephrol, Hypertens Unit, Barcelona, Spain

[8] Univ Coll London UCL, UCL Hosp Biomed Res Ctr, Inst Cardiovasc Sci, Natl Inst Hlth Res, London, England

来源：

HYPERTENSION | 2024年 / 81卷 / 11期

关键词：

blood pressure; blood pressure monitoring; ambulatory; hypertension; mortality; population; AMBULATORY BLOOD-PRESSURE; EUROPEAN-SOCIETY; TASK-FORCE; ARTERIAL-HYPERTENSION; ASSOCIATION; MANAGEMENT; GUIDELINES; PROGNOSIS; DISEASE; OFFICE;

D O I：

10.1161/HYPERTENSIONAHA.124.23276

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

BACKGROUND: Resistant hypertension is characterized by elevated blood pressure (BP) despite using 3 antihypertensive agents. Ambulatory BP monitoring (ABPM) detects the presence of white-coat resistant hypertension (24-hour BP <130/80 mm Hg). The aim of the study was to evaluate risks of death in resistant hypertension compared with controlled hypertension, as well as in ABPM-confirmed (24-hour BP >= 130 or 80 mm Hg), versus white-coat resistant hypertension. METHODS: We selected 8146 patients with controlled hypertension (office BP <140/90 mm Hg while being treated with <= 3 antihypertensive drugs) and 8577 with resistant hypertension (BP >= 140 or >= 90 mm Hg while being treated with >= 3 drugs). All-cause and cardiovascular mortalities (median follow-up, 9.7 years) were compared between groups, as well as between patients with white-coat (3289) and ABPM-confirmed (5288) resistant hypertension. Hazard ratios (HRs) from Cox models after adjustment for clinical confounders were used for comparisons. RESULTS: Compared with controlled hypertension, resistant hypertension was associated with an increased risk in all-cause (HR, 1.21 [95% CI, 1.12-1.30]) and cardiovascular mortalities (HR, 1.33 [95% CI, 1.17-1.51]) in confounder-adjusted models. Compared with white-coat, ABPM-confirmed resistant hypertension was associated with an increased risk of all-cause (HR, 1.45 [95% CI, 1.32-1.60]) and cardiovascular (HR, 1.68 [95% CI, 1.43-1.98]) mortalities. When ABPM-confirmed and white-coat resistant hypertension were separately compared with controlled hypertension, only the former was associated with an increased risk of death and cardiovascular death (HR, 1.36 [95% CI, 1.26-1.48] and 1.56 [95% CI, 1.36-1.79]), respectively. CONCLUSIONS: ABPM-confirmed resistant hypertension is associated with an increased risk of death and cardiovascular death with respect to both controlled hypertension and white-coat resistant hypertension.

引用

页码：2350 / 2356

页数：7