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Resistant hypertension in patients with chronic aortic dissection
H Eggebrecht1, A Schmermund, C von Birgelen
1Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany. holger.eggebrecht@uni-essen.de
Journal of Human Hypertension
|November 27, 2004
Summary
Achieving strict blood pressure control in aortic dissection (AD) patients often requires multiple antihypertensive drugs. However, 40% experience resistant hypertension, particularly younger, obese individuals.
Area of Science:
- Cardiology
- Vascular Medicine
- Hypertension Management
Background:
- Strict blood pressure control is crucial for managing patients with aortic dissection (AD).
- Achieving target blood pressure levels in AD patients can be challenging.
Purpose of the Study:
- To evaluate antihypertensive medical therapy and blood pressure (BP) control in patients with chronic AD.
- To identify factors associated with effective BP control versus resistant hypertension in AD.
Main Methods:
- Retrospective chart review of 40 patients with chronic AD.
- Analysis of clinical variables, serial BP measurements, and antihypertensive drug regimens.
- Patients categorized into effective BP control (<135/80 mmHg) and resistant hypertension (≥135/80 mmHg on ≥3 drugs) groups.
Main Results:
- Effective BP control was achieved in 60% of patients; 40% had resistant hypertension.
- Resistant hypertension group required significantly more antihypertensive drugs (median 5 vs. 4).
- Resistant hypertension patients were younger and had higher body mass index.
Conclusions:
- Effective BP control in chronic AD is achievable but often necessitates multiple antihypertensive medications.
- A significant subset of younger, obese AD patients exhibits resistant hypertension despite aggressive medical management.
- Further research into optimal therapeutic strategies for resistant hypertension in AD is warranted.