Resistance to antihypertensive treatment and long-term risk: The atherosclerosis risk in communities study

The Journal of Clinical HypertensionWijkman 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.

Read the full article on The Journal of Clinical Hypertension