Resistance Hypertension and Achievement of Target Blood Pressure

Abstract

Aim: To evaluate the characteristics of patients with resistant arterial hypertension (RAH) and assessed the prevalence of true resistant hypertension in patients who takes 3 and more antihypertensive agents.

Materials and methods: The study included 1146 patients with AH who received 3 or more antihypertensive drugs. The average level of systolic (SBP) / diastolic (DBP) blood pressure was (174,60 ± 0,64) / (100,50 ± 0,38) mm Hg.

Results: Our data showed that in patients who received 3 or more drugs in (31%) goal blood pressure was not reached, it means true resistant hypertension. 3 drugs were received (51.4%) patients, 4 drugs - (37.1%), 5 drugs - (9.1%), and 6 drugs - (2.4%) of patients. ACE inhibitors were prescribed in 65.5%, calcium antagonists - in 69.9%, diuretics - in 91.8%. Beta-blockers - 75.5%, AT II blockers - 33.5%, aldosterone receptor blockers - 12.8%. Fixed combinations - 71.9%. Patients who did not achieve targeted SBP (31%) had higher cortisol (155.0 ± 44.0 vs 35.9 ± 20.8 ng/l), left ventricular mass index (147.5 ± 3.46 vs 135.3 ± 1.74 g/m2), obesity (42.9% vs 37.5%), kidney abnormality (2.7% vs 0.8%), nephropathy (1.3% vs 0.2%), and heart failure (16.9% vs 8.5%). Patients taking 4 and more drugs had higher glucose levels - (6.20 ± 0.09) mmol/l vs (5.90 ± 0.14) mmol/l (p <0.05) and the lower renin (31.10 ± 5.91) ng/l vs (218.30 ± 15.73) ng/l (p <0.05).

Conclusion: patients who received 3 or more antihypertensive drugs in 31% had true resistant hypertension. They had higher blood cortisol level, left ventricular mass index, obesity, kidney abnormality and more often heart failure.