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Prevalence and Comorbidities of Resistant Hypertension: A Collaborative Population-Based Observational Study

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Abstract

Background

Resistant hypertension, is a clinical condition that may confer high cardiovascular risk. Aim of the observational study was to evaluate the prevalence of resistant hypertension, and the association with cardiovascular risk factors or diseases in the Verona urban area.

Design and Methods

Eleven family doctors retrieved anonymised data concerning blood pressure, diagnosis of hypertension and treatments from a population of 17,502 adult subjects. The prevalence of resistant hypertension was estimated considering patients who had been consecutively treated with at least four antihypertensive medications, regardless of blood pressure values. Further search concerning the clinical characteristics associated with resistant hypertension was performed in a random subsample of 55 patients.

Results

The prevalence of hypertension was 21.9%, that of resistant hypertension was 2.1%, approximately 10% of the whole hypertensive population. High prevalence of diabetes mellitus (53%) and hyperlipidemia (83%) was found in association with resistant hypertension. As for end organ damage, high prevalence of carotid artery stenosis (45%), ischemic heart disease (43%) and left ventricular hypertrophy (40%) was observed in patients with resistant hypertension. Blood pressure was higher than 140/90 mmHg in 58% of patients in spite of treatment with four or more different antihypertensive drugs. The average age, systolic and pulse pressure were significantly higher in the subgroup of patients with resistant hypertension.

Conclusions

Patients with resistant hypertension are characterised by a higher systolic and pulse pressure and a very high attributable cardiovascular risk, due to high prevalence of cardiovascular risk factors and overt organ damage and cardiovascular disease.

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Acknowledgements

We would like to thank the physicians from the SIMG (Italian Society of Primary Care Physicians) who took part in the study for their valuable contribution.

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Authors and Affiliations

  1. Section of General Medicine and Hypertension, Department of Medicine, University of Verona, Policlinico GB Rossi, Piazzale LA Scuro 10, 37134, Verona, Italy

    Simone Romano, Chiara Idolazzi, Cristiano Fava, Luigi Fondrieschi, Pietro Delva, Lorella Branz, Angela Donato, Andrea Dalbeni & Pietro Minuz

  2. SIMG, Italian Society of Primary Care Physicians, Florence, Italy

    Mario Celebrano

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  1. Simone Romano
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  2. Chiara Idolazzi
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  10. Pietro Minuz
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Corresponding author

Correspondence to Pietro Minuz.

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Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee for Clinical Research of the Provinces of Verona and Rovigo. This article does not contain any studies with animals performed by any of the authors.

Informed consent

The 55 subjects who agreed to the inspection of their clinical records gave their informed consent.

Additional information

This article is part of the topical collection on Epidemiology of Hypertension.

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Romano, S., Idolazzi, C., Fava, C. et al. Prevalence and Comorbidities of Resistant Hypertension: A Collaborative Population-Based Observational Study. High Blood Press Cardiovasc Prev 25, 295–301 (2018). https://doi.org/10.1007/s40292-018-0268-x

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