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Cardiovascular morbidity of severe resistant hypertension among treated uncontrolled hypertensives: a 4-year follow-up study

Data regarding the prognosis of resistant hypertension (RHTN) with respect to its severity is limited. We investigated the cardiovascular risk of severe RHTN in a prospective observational study. A cohort of 1700 hypertensive patient with treated uncontrolled HTN was followed for a mean period of 3....

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Published in:Journal of human hypertension 2018-07, Vol.32 (7), p.487-493
Main Authors: Kasiakogias, Alexandros, Tsioufis, Costas, Dimitriadis, Kyriakos, Konstantinidis, Dimitrios, Koumelli, Areti, Leontsinis, Ioannis, Andrikou, Eirini, Vogiatzakis, Nikos, Marinaki, Smaragdi, Petras, Dimitrios, Fragoulis, Christos, Konstantinou, Konstantinos, Papademetriou, Vasilios, Tousoulis, Dimitrios
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Tsioufis, Costas
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Vogiatzakis, Nikos
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Fragoulis, Christos
Konstantinou, Konstantinos
Papademetriou, Vasilios
Tousoulis, Dimitrios
description Data regarding the prognosis of resistant hypertension (RHTN) with respect to its severity is limited. We investigated the cardiovascular risk of severe RHTN in a prospective observational study. A cohort of 1700 hypertensive patient with treated uncontrolled HTN was followed for a mean period of 3.6 ± 1.8 years. At baseline, standard clinical and laboratory workup was performed, including testing for secondary causes of RHT where applicable. Three groups were identified depending on presence of RHTN (office-based uncontrolled HTN under at least three drugs including a diuretic) and levels of office systolic blood pressure (BP): 1187 patients (70%) without RHTN, 313 (18%) with not-severe RHTN (systolic BP 
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We investigated the cardiovascular risk of severe RHTN in a prospective observational study. A cohort of 1700 hypertensive patient with treated uncontrolled HTN was followed for a mean period of 3.6 ± 1.8 years. At baseline, standard clinical and laboratory workup was performed, including testing for secondary causes of RHT where applicable. Three groups were identified depending on presence of RHTN (office-based uncontrolled HTN under at least three drugs including a diuretic) and levels of office systolic blood pressure (BP): 1187 patients (70%) without RHTN, 313 (18%) with not-severe RHTN (systolic BP &lt; 160 mmHg) and 200 (12%) with severe RHTN (systolic BP ≥ 160 mmHg). Endpoint of interest was cardiovascular morbidity set as the composite of coronary heart disease and stroke. During follow-up, incidence rates of cardiovascular events per 1000 person-years were 7.1 cases in the non-RHTN group, 12.4 cases in the not-severe RHTN group and 18 cases in the severe RHTN group. Unadjusted analysis showed that compared to uncontrolled patients without RHTN, patients with not-severe RHTN exhibited a similar risk but patients with severe RHTN had a significantly higher risk, by 2.5 times (CI: 1.28–4.73, p  = 0.007). Even after multivariate adjustment for established risk factors including BP levels and isolated systolic HTN, severe RHTN remained as an independent predictor of the cardiovascular outcome (OR: 2.30, CI: 1.00–5.29, p  = 0.05). 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subjects 692/699/75/243
692/700/1750
Blood pressure
Cardiovascular disease
Cardiovascular diseases
Care and treatment
Coronary artery disease
Development and progression
Diagnosis
Epidemiology
Health Administration
Health risk assessment
Heart diseases
Hypertension
Medicine
Medicine & Public Health
Morbidity
Prognosis
Public Health
Risk factors
title Cardiovascular morbidity of severe resistant hypertension among treated uncontrolled hypertensives: a 4-year follow-up study
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