Resistant Hypertension and Related Outcomes in a Cohort of Patients with Cardiorenal Multimorbidity Hospitalized in an Internal Medicine Ward

被引：1

作者：

Gigante, Antonietta ^{[1
]}

Cianci, Rosario ^{[1
]}

Brigato, Claudia ^{[1
]}

Melena, Michele ^{[1
]}

Acquaviva, Erika ^{[1
]}

Toccini, Ludovica ^{[1
]}

Pellicano, Chiara ^{[1
]}

Rosato, Edoardo ^{[1
]}

Muscaritoli, Maurizio ^{[1
]}

机构：

[1] Sapienza Univ Rome, Dept Translat & Precis Med, Viale Univ 37, I-00185 Rome, Italy

来源：

HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION | 2023年 / 30卷 / 6期

关键词：

Resistant hypertension; Cardiorenal multimorbidity; Heart failure; Chronic kidney disease; DISEASE; RISK;

D O I：

10.1007/s40292-023-00609-x

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

IntroductionResistant hypertension (RH) is characterized by the failure to reach a goal blood pressure despite the administration of three medications at maximally tolerated doses, one of which being a diuretic. RH can be observed in a variety of clinical conditions, such as heart failure and reduced renal function and may confer high cardiovascular risk.AimTo evaluate the prevalence of RH and its association with clinical outcomes; the primary outcome was in-hospital mortality and the composite outcome was all-cause of mortality and morbidity in a cohort of patients with cardiorenal multimorbidity hospitalized in an internal medicine ward.MethodsWe conducted a retrospective analysis of consecutive hypertensive patients with cardiorenal multimorbidity. The composite outcome incorporated all-cause of in-hospital mortality and occurrence of sepsis, pulmonary embolism, acute coronary syndrome, stroke and renal replacement therapy.ResultsWe collected data in 141 inpatients with a mean age of 77 years +/- 10 (males 65.9 %), estimated glomerular filtration rate of 34 +/- 18.6 ml/min with length of stay of 17 +/- 12 days. The prevalence of RH was 52.4%. In-hospital mortality was observed in 24 patients (17%) and the composite outcome occurred in 87 patients (61.7%) and among these 74 (85.1%) were patients with RH. Free survival for composite outcome was significantly higher in patients without RH than patients with RH (log rank 7.52, p = 0.006).Resistant hypertension was a risk factor for composite outcome [HR 1.857(C.I. 1.170-2.946, p = 0.009)].ResultsWe collected data in 141 inpatients with a mean age of 77 years +/- 10 (males 65.9 %), estimated glomerular filtration rate of 34 +/- 18.6 ml/min with length of stay of 17 +/- 12 days. The prevalence of RH was 52.4%. In-hospital mortality was observed in 24 patients (17%) and the composite outcome occurred in 87 patients (61.7%) and among these 74 (85.1%) were patients with RH. Free survival for composite outcome was significantly higher in patients without RH than patients with RH (log rank 7.52, p = 0.006).Resistant hypertension was a risk factor for composite outcome [HR 1.857(C.I. 1.170-2.946, p = 0.009)].ConclusionIn patients with cardiorenal multimorbidity there is a high proportion of RH that represents a risk factor for composite outcome but not for in-hospital mortality.

引用

页码：585 / 590

页数：6