期刊
JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION
卷 8, 期 6, 页码 405-413出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jash.2014.03.003
关键词
Resistant hypertension; outcomes; severe hypertension; antihypertensives
资金
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, and Department of Health and Human Service [U01 NS041588]
- National Heart Lung and Blood Institute [R01 HL080477]
Apparent treatment-resistant hypertension (aTRH) is defined as uncontrolled hypertension despite the use of three or more antihypertensive medication classes or controlled hypertension while treated with four or more antihypertensive medication classes. We evaluated the association of aTRH with incident stroke, coronary heart disease (CHD), and all-cause mortality. Participants from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) Study treated for hypertension with aTRH (n = 2043) and without aTRH (n = 12,479) were included. aTRH was further categorized as controlled aTRH (>= 4 medication classes and controlled hypertension) and uncontrolled aTRH (>= 3 medication classes and uncontrolled hypertension). Over a median of 5.9, 4.4, and 6.0 years of follow-up, the multivariable adjusted hazard ratio for stroke, CHD, and all-cause mortality associated with aTRH versus no aTRH was 1.25 (0.94-1.65), 1.69 (1.27-2.24), and 1.29 (1.14-1.46), respectively. Compared with controlled aTRH, uncontrolled aTRH was associated with CHD (hazard ratio, 2.33; 95% confidence interval, 1.21-4.48), but not stroke or mortality. Comparing controlled aTRH with no aTRH, risk of stroke, CHD, and all-cause mortality was not elevated. aTRH was associated with an increased risk for coronary heart disease and all-cause mortality. (C) 2014 American Society of Hypertension. All rights reserved.
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