Risk of heart failure in ambulatory resistant hypertension: a meta-analysis of observational studies

被引:3
作者
Coccina, Francesca [1 ]
Salles, Gil F. [2 ]
Banegas, Jose R. [3 ,4 ]
Hermida, Ramon C. [5 ,6 ]
Bastos, Jose M. [7 ,8 ]
Cardoso, Claudia R. L. [2 ]
Salles, Guilherme C. [9 ]
Sanchez-Martinez, Mercedes [3 ,4 ,10 ]
Mojon, Artemio [5 ,6 ]
Fernandez, Jose R. [5 ,6 ]
Costa, Carlos [11 ]
Carvalho, Simao [11 ]
Faia, Joao [11 ]
Pierdomenico, Sante D. [1 ]
机构
[1] Univ Gabriele Annunzio, Dept Innovat Technol Med & Dent, I-66100 Chieti, Italy
[2] Univ Fed Rio de Janeiro, Sch Med, Dept Internal Med, Rio De Janeiro, Brazil
[3] Univ Autonoma Madrid, Dept Prevent Med & Publ Hlth, Madrid, Spain
[4] CIBERESP, Madrid, Spain
[5] Univ Vigo, Atlantic Res Ctr Telecommun Technol atlanTT, Bioengn & Chronobiol Labs, Vigo, Spain
[6] Galicia Hlth Res Inst IIS Galicia Sur, Bioengn & Chronobiol Res Grp, SERGAS UVIGO, Vigo, Spain
[7] Univ Aveiro, Sch Hlth Sci, P-3810193 Aveiro, Portugal
[8] Univ Aveiro, Inst Biomed iBiMED, Aveiro, Portugal
[9] Univ Fed Rio de Janeiro, Polytech Sch, Deparment Civil Engn, Rio De Janeiro, Brazil
[10] Univ Catolica Santa Teresa Jesus Avila, Dept Hlth Sci, Avila, Spain
[11] Ctr Hosp Baixo Vouga, Cardol Dept, Aveiro, Portugal
关键词
Ambulatory blood pressure; Heart failure; Hypertension; Resistant hypertension; BLOOD-PRESSURE; PROGNOSTIC VALUE; SPIRONOLACTONE; EMPAGLIFLOZIN; EPIDEMIOLOGY; PREVALENCE; OUTCOMES; IMPACT; BIAS;
D O I
10.1038/s41440-024-01632-8
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
The impact of ambulatory resistant hypertension (ARH) on the occurrence of heart failure (HF) is not yet completely known. We performed for the first time a meta-analysis, by using published data or available data from published databases, on the risk of HF in ARH. Patients with ARH (24-h BP >= 130/80 mmHg during treatment with >= 3 drugs) were compared with those with controlled hypertension (CH, clinic BP < 140/90 mmHg and 24-h BP < 130/80 mmHg regardless of the number of drugs used), white coat uncontrolled resistant hypertension (WCURH, clinic BP >= 140/90 mmHg and 24-h BP < 130/80 mmHg in treated patients) and ambulatory nonresistant hypertension (ANRH, 24-h BP >= 130/80 mmHg during therapy with <= 2 drugs). We identified six studies/databases including 21,365 patients who experienced 692 HF events. When ARH was compared with CH, WCURH, or ANRH, the overall adjusted hazard ratio for HF was 2.32 (95% confidence interval (CI) 1.45-3.72), 1.72 (95% CI 1.36-2.17), and 2.11 (95% CI 1.40-3.17), respectively, (all P < 0.001). For some comparisons a moderate heterogeneity was found. Though we did not find variables that could explain the heterogeneity, sensitivity analyses demonstrated that none of the studies had a significant influential effect on the overall estimate. When we evaluated the potential presence of publication bias and small-study effect and adjusted for missing studies identified by Duval and Tweedie's method the estimates were slightly lower but remained significant. This meta-analysis shows that treated hypertensive patients with ARH are at approximately twice the risk of developing HF than other ambulatory BP phenotypes.
引用
收藏
页码:1235 / 1245
页数:11
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