Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitalsopen access
- Kim, Sehun; Park, Jin Joo; Shin, Mi-Seung; Kwak, Choong Hwan; Lee, Bong-Ryeol; Park, Sung-Ji; Lee, Hae-Young; Kim, Sang-Hyun; Kang, Seok-Min; Yoo, Byung-Su; Chung, Joong-Wha; Choi, Si Wan; Jo, Sang-Ho; Shin, Jinho; Choi, Dong-Ju
- Issue Date
- KOREAN ASSOC INTERNAL MEDICINE
- Apparent treatment resistant hypertension; Prevalence; Characteristics; Independent predictor; Korea
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.36, no.4, pp.888 - 897
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Start Page
- End Page
- Background/Aims: To examine the prevalence and clinical characteristics of apparent treatment-resistant hypertension among ambulatory hypertensive patients. Methods: We enrolled adult ambulatory hypertensive patients at 13 well-qualified general hospitals in Korea from January to June 2012. Apparent resistant hypertension was defined as an elevated blood pressure >140/90 mmHg with the use of three antihypertensive agents, including diuretics, or a >= 4 antihypertensives, regardless of the blood pressure. Controlled hypertension was defined as a blood pressure within the target using three antihypertensives, including diuretics. Results: Among 16,915 hypertensive patients, 1,172 (6.9%) had controlled hypertension, and 1,514 (8.9%) had apparent treatment-resistant hypertension. Patients with apparent treatment-resistant hypertension had an earlier onset of hypertension (56.8 years vs. 58.8 years, p = 0.007) and higher body mass index (26.3 kg/m(2) vs. 24.9 kg/m(2), p < 0.001) than those with controlled hypertension. Drug compliance did not differ between groups. In the multivariable analysis, earlier onset of hypertension (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p < 0.001) and the presence of comorbidities (OR, 2.06; 95% CI, 1.27 to 3.35; p < 0.001), such as diabetes mellitus, ischemic heart disease, heart failure, and chronic kidney disease, were independent predictors. Among the patients with apparent treatment-resistant hypertension, only 5.2% were receiving a >= 2 antihypertensives at maximally tolerated doses. Conclusions: Apparent treatment-resistant hypertension prevalence is 8.9% among ambulatory hypertensive patients in Korea. An earlier onset of hypertension and the presence of comorbidities are independent predictors. Optimization of medical treatment may reduce the rate of apparent treatment-resistant hypertension.
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- College of Medicine > Department of Medicine > Journal Articles
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