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Prevalence and risk factors for resistant hypertension among hypertensive patients from a developing country
W A Nuwan Kumara1, Thisara Perera, Mekhala Dissanayake
1Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. priyanga.ranasinghe@gmail.com.
Insights
Resistant hypertension affects nearly one-fifth of South Asian hypertensive patients, with obesity and diabetes mellitus being key risk factors. Understanding these factors is crucial for managing uncontrolled blood pressure.
Area of Science:
- Cardiology
- Hypertension Research
- Public Health
Background:
- Investigating the prevalence and risk factors of resistant hypertension (RHT) in a South Asian hypertensive cohort.
- Addressing the need for specific risk factor identification in diverse ethnic populations.
Purpose of the Study:
- To determine the prevalence of resistant hypertension.
- To identify differential risk factors associated with resistant hypertension in South Asian patients.
Main Methods:
- A descriptive cross-sectional study involving 277 hypertensive patients at a cardiology clinic.
- Data collected via interviewer-administered questionnaires.
- Binary logistic regression analysis to identify significant co-variants associated with RHT.
Main Results:
- 41.1% of patients had uncontrolled blood pressure, with 19.1% having resistant hypertension.
- Older age, longer hypertension duration, diabetes mellitus, and obesity (BMI > 27.5 kg/m2) were significantly associated with RHT.
- Therapeutic inertia contributed to uncontrolled blood pressure in 27.8% of cases.
Conclusions:
- A substantial portion of hypertensive patients experience uncontrolled blood pressure, with resistant hypertension being prevalent.
- Obesity and diabetes mellitus are significant risk factors for resistant hypertension in this population.
- Therapeutic inertia plays a notable role in the management of uncontrolled hypertension.
Background:
To study the prevalence and define deferential risk factors for 'Resistant' hypertension (RHT) in a hypertensive population of South Asian origin.
Methods:
A descriptive cross-sectional study was carried out among hypertensive patients attending clinics at the Cardiology Unit, Colombo from July-October 2009. All the patients with hypertension who provided informed written consent were recruited to the study (n = 277). A pre-tested interviewer-administered questionnaire was used for data collection. A binary logistic-regression analysis was performed in all patients with 'presence of RHT' as the dichotomous dependent variable and other independent co-variants.
Results:
Mean age was 61 ± 10.3 years and 50.2% were males. The mean of average systolic and diastolic blood pressures (BP) were 133.04 ± 12.91 mmHg and 81.07 ± 6.41 mmHg respectively. Uncontrolled BP was present in 41.1% (n = 114) of patients, of which RHT was present in 19.1% (n = 53). Uncontrolled BP were due to 'therapeutic inertia' in 27.8% of the study population. Those with diabetes mellitus, obesity (BMI > 27.5 kg/m2) and those who were older than 55 years were significantly higher in the RHT group than in the non-RHT group. In the binary logistic regression analysis older age (OR:1.36), longer duration of hypertension (OR:1.76), presence of diabetes mellitus (OR:1.67) and being obese (OR:1.84) were significantly associated with RHT.
Conclusion:
A significant proportion of the hypertensive patients were having uncontrolled hypertension. Nearly 1/5th of the population was suffering from RHT, which was significantly associated with the presence of obesity and diabetes mellitus. Therapeutic inertia seems to contribute significantly towards the presence of uncontrolled BP.
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