Resistance to antihypertensive treatment and long-term risk: The atherosclerosis risk in communities study
The Journal of Clinical Hypertension — Wijkman MO, Malachias MVB, Claggett BL, et al. | September 24, 2021
The authors conclude that apparent resistant hypertension (ARH) predicted long-term risk in patients without cardiovascular illness, regardless of whether traditional or more strict blood pressure (BP) criteria were used.
They evaluated the prognostic impact of ARH according to contemporary BP goals in 9,612 candidates of the Atherosclerosis Risk in Communities (ARIC) study without previous cardiovascular disease.
Age, gender, race, study center, BMI, heart rate, smoking, eGFR, LDL, HDL, triglycerides, and diabetes were all taken into account in the Cox regression models.
One hundred thirty-three candidates (3.8% of those treated) had ARH when the traditional BP goal was used.
When the more stringent BP goal was used, 785 candidates (22.6% of those treated) were reclassified from controlled hypertension to uncontrolled hypertension (n = 725) or ARH (n = 60).
ARH was related to an increased risk for a composite endpoint (all-cause mortality, hospitalization for myocardial infarction, stroke, or heart failure) over a median follow-up time of 19 years, independent of whether traditional or more rigorous blood pressure goals were applied.