Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitalsApparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals
- Other Titles
- Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals
- Authors
- Sehun Kim; Jin Joo Park; Mi-Seung Shin; Choong Hwan Kwak; Bong-Ryeol Lee; Sung-Ji Park; Hae-Young Lee; Sang Hyun Kim; Seok-Min Kang; Byung-Su Yoo; Joong-Wha Chung; Si Wan Choi; Sang-Ho Jo; Jinho Shin; Dong-Ju Choi
- Issue Date
- Jul-2021
- Publisher
- 대한내과학회
- Keywords
- Apparent treatment resistant hypertension; Prevalence; Characteristics; Independent predictor; Korea
- Citation
- The Korean Journal of Internal Medicine, v.36, no.4, pp.888 - 897
- Journal Title
- The Korean Journal of Internal Medicine
- Volume
- 36
- Number
- 4
- Start Page
- 888
- End Page
- 897
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81678
- DOI
- 10.3904/kjim.2019.361
- ISSN
- 1226-3303
- Abstract
- 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 ≥ 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/m2 vs. 24.9 kg/m2, 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 ≥ 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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