Prevalence and characteristics of resistant hypertensive patients in an Asian population

Background: Resistant hypertension is a well-recognized clinical challenge yet there are no reported data on its prevalence in Pakistan. These patients are subjected to a higher risk of developing hypertensive complications. The objective of our study was to evaluate the prevalence and determinants of resistant hypertension in an Asian cohort of hypertensive patients. Methods: This cross-sectional study was carried out among hypertensive patients visiting a tertiary care hospital in Karachi from September-December 2015. Patient data and characteristics were recorded using a pre-coded questionnaire. Morisky and Berlin questionnaires were used to assess compliance to medications and determine the risk of developing obstructive sleep apnea, respectively. Pearson's chisquare test was used to analyze statistical differences between hypertensive patients and related factors. Results: A total of 515 patients were included in the study. Overall, 12% of the total patients (n = 62) were resistant hypertensives and 25% (n = 129) had pseudo-resistant hypertension. Resistant patients were more often females, older and had a higher body mass index (all P < 0.001). Use of painkillers and noncompliance to dietary recommendations were found to be significant determinants of resistant hypertension. Prevalence of comorbid conditions, including diabetes (p = 0.33), hyperlipidemia (p = 0.46), and chronic kidney disease (p = 0.23), was not significantly higher in patients with resistant hypertension. Conclusion: Nearly one in ten hypertensive patients had true resistant hypertension, and twenty-five percent of patients had pseudo-resistance. Resistance hypertensions is significantly associated with female gender, older age, obesity, dietary noncompliance and increased use of NSAIDs. (C) 2017 Published by Elsevier B.V. on behalf of Cardiological Society of India.