Clin Hypertens.
2016 ;22(1):8. 10.1186/s40885-016-0045-x.
Prevalence of resistant hypertension and associated factors for blood pressure control status with optimal medical therapy using Korean ambulatory blood pressure monitoring registry data
- Affiliations
-
- 1Cardiology division, Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro Sungdong-Ku, Seoul #133-792, South Korea. jhs2003@hanyang.ac.kr
- 2Department of Internal Medicine, Yonsei University, School of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Chonnam University, School of Medicine, GwangJu, Korea.
- 4Department of Internal Medicine, Catholic University, College of Medicine, Bucheon, Korea.
- 5Department of Internal Medicine, Seoul National University, School of Medicine, Bundang, Korea.
- 6Department of Internal Medicine, Kyung Hee University, School of Medicine, Seoul, Korea.
- 7Department of Internal Medicine, Ewha Womans University, School of Medicine, Seoul, Korea.
- 8Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea.
- KMID: 2380214
- DOI: http://doi.org/10.1186/s40885-016-0045-x
Abstract
- BACKGROUND
Resistant hypertension (RH) may be one of the cause of the plateau in improving the control rate in hypertension (HT) management. The misdiagnosis of RH by clinic blood pressure (BP) is important clinical problem. Aim of the study were to investigate the prevalence of RH by ambulatory blood pressure monitoring (ABPM) and the factor associated with control status of ambulatory BPs.
METHODS
For 1230 subjects taking one or more antihypertensive medication (AHM) enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, the prevalence of RH was calculated which was defined as uncontrolled BP by three AHM classes including diuretic or BP in need of four or more AHM classes. The prevalence determined by clinic versus ambulatory BP was compared.
RESULTS
The age was 59.3 +/- 12.5 years, and 44.3 % were female (n = 1230). Among them 72 subjects were taking three AHM drugs including diuretics and 105 subjects were taking four or more AHM classes. With uncontrolled daytime ambulatory BP in 41 among 72 subjects, prevalence of RH was 11.9 % (146/1230). By using nighttime BP criteria, there was significant difference in the prevalence of RH for clinic versus nighttime BP (146/177 vs. 159/177, p = 0.0124). For control status of daytime BP, masked uncontrolled BP was 16.9 % and controlled BP with white-coat effect was 14.1 %. For nighttime BP control status, odd ratios for smoking (0.624), drinking (1.512), coronary artery disease (0.604), calcium antagonist (1.705), and loop diuretics (0.454) were all significant.
CONCLUSION
The prevalence itself was 11.9 % by daytime BP and it was significantly higher when using nighttime BP criteria. Control status of daytime BP was misclassified in 31.0 %. Smoking, drinking, coronary artery disease, calcium antagonist, and loop diuretics were associated with nighttime BP control status.
Keyword
MeSH Terms
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Blood Pressure Monitoring, Ambulatory*
Blood Pressure*
Calcium
Coronary Artery Disease
Diagnostic Errors
Diuretics
Drinking
Female
Humans
Hypertension*
Masked Hypertension
Masks
Prevalence*
Smoke
Smoking
Sodium Potassium Chloride Symporter Inhibitors
Calcium
Diuretics
Smoke
Sodium Potassium Chloride Symporter Inhibitors
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