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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 
Citation
 KOREAN JOURNAL OF INTERNAL MEDICINE, Vol.36(4) : 888-897, 2021-07 
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
ISSN
 1226-3303 
Issue Date
2021-07
MeSH
Adult ; Antihypertensive Agents / pharmacology ; Antihypertensive Agents / therapeutic use ; Blood Pressure ; Cross-Sectional Studies ; Drug Resistance ; Hospitals, General* ; Humans ; Hypertension* / diagnosis ; Hypertension* / drug therapy ; Hypertension* / epidemiology ; Prevalence ; Republic of Korea / epidemiology
Keywords
Apparent treatment resistant hypertension ; Characteristics ; Independent predictor ; Korea ; Prevalence
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.

Conclusion: 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.
Files in This Item:
T202125392.pdf Download
DOI
10.3904/kjim.2019.361
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187823
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