Unit:
Κατεύθυνση ΒιοστατιστικήLibrary of the School of Health Sciences
Author:
Κορδαλής Αθανάσιος
Supervisors info:
Κωνσταντίνος Τσιούφης, Παναγιώτα Τουλούμη, Απόστολος Μπουρνέτας
Original Title:
Επιπολασμός, επίπτωση και προγνωστική αξία της ανθεκτικής υπέρτασης για την εκδήλωση καρδιαγγειακών συμβάντων σε μια κοόρτη υπερτασικών ασθενών
Translated title:
Prevalence, incidence and prognostc value of resistant hypertension for cardiovascular morbidity in treated hypertensives
Summary:
Objective: Little is known regarding the clinical course and prognosis of
resistant hypertension (RH). We evaluated predictors of persistent RH and the
associated cardiovascular risk.
Methods: We studied 1911 treated hypertensive patients [Mean age (SD) 59 (11)
years, 49% males] for a median period of 3.9 years. At baseline, clinical data
were collected and patients underwent echocardiographic measurements, routine
blood testing and additional workup for exclusion of secondary causes of RH
(office-based uncontrolled hypertension under at least 3 drugs including a
diuretic or controlled hypertension under 4 or more drugs). Endpoint of
interest was the composite of coronary artery disease and stroke.
Results: Four groups were identified depending on presence or absence of RH at
baseline and follow-up: 1153 patients (60%) never having RH, 189 (10%) with
resolved RH, 204 (11%) with incident RH and 365 (19%) with persistent RH. Two
thirds of the patients with RH at baseline remained resistant at the end of the
study. Independent variables associated with both incident and persistent RH
were diabetes mellitus, history of cardiovascular disease, hypertension
duration, systolic blood pressure, left ventricular hypertrophy and glomerular
filtration rate. Persistent RH compared to never-having RH was associated with
a 2.2-fold increased risk for cardiovascular morbidity (95% CI: 1.21-4.05,
p=0.01) after adjustment for risk factors.
Conclusions: In treated hypertensive patients, among prospective RH dynamic
patterns, persistent RH is frequent and independently associated with adverse
cardiovascular prognosis.
Keywords:
Hypertension, Resistant, Cardiovascular morbidity, Incidence, Prevalence
Number of references:
203
