Resistant hypertension: do all definitions describe the same patients?

Area of Science:

• Cardiology
• Nephrology
• Endocrinology

Background:

• Resistant hypertension (RH) affects numerous patients, posing significant cardiovascular risks.
• Current definitions of RH, including the classical (CD) and new (ND) definitions, may characterize different patient cohorts.
• Understanding these differences is crucial for effective patient management and risk stratification.

Purpose of the Study:

• To evaluate whether the classical definition (CD) and the new definition (ND) of resistant hypertension identify similar patient groups.
• To compare the clinical and laboratory characteristics of patients with controlled versus uncontrolled RH.

Main Methods:

• A cohort of 124 RH patients was analyzed.
• Patients were classified based on blood pressure (BP) control under their prescribed antihypertensive therapy.
• Clinical data, laboratory values (including glucose, cholesterol, LDL, and triglycerides), and office BP were recorded and analyzed.

Main Results:

• Uncontrolled RH patients exhibited a higher prevalence of diabetes (72% vs. 49%) compared to controlled RH patients.
• Higher levels of plasma glucose, cholesterol, LDL-cholesterol, and triglycerides were observed in the uncontrolled RH group.
• Multivariate analysis identified diabetes and elevated LDL-cholesterol as independent predictors of uncontrolled RH.

Conclusions:

• While both definitions identify phenotypically similar RH patients, uncontrolled RH is strongly associated with diabetes mellitus and dyslipidemia.
• These findings highlight the importance of aggressive management of metabolic factors in patients with resistant hypertension.
• Further research is warranted to refine RH definitions and optimize treatment strategies.