1. Is resistant hypertension an independent predictor of all-cause mortality in individuals with type 2 diabetes? A prospective cohort study
- Author
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Solini, A, Penno, G, Orsi, E, Bonora, E, Fondelli, C, Trevisan, R, Vedovato, M, Cavalot, F, Lamacchia, O, Baroni, M, Nicolucci, A, Pugliese, G, Bollanti, L, Alessi, E, Vitale, M, Cirrito, T, Cavallo-Perin, P, Gruden, G, Lorenzati, B, Trovati, M, Di Martino, L, Mazzaglia, F, Zerbini, G, Martina, V, Maestroni, S, Capuano, V, Palmieri, E, Lunati, E, Grancini, V, Resi, V, Pontiroli, A, Veronelli, A, Zecchini, B, Arosio, M, Montefusco, L, Rossi, A, Adda, G, Corsi, A, Albizzi, M, Zoppini, G, Avogaro, A, Pucci, L, Lucchesi, D, Russo, E, Garofolo, M, Dotta, F, Nigi, L, Morano, S, Filardi, T, Turinese, I, Rossetti, M, Buzzetti, R, Foffi, C, Cignarelli, M, Pinnelli, S, Monaco, L, Giorgino, F, Laviola, L, Natalicchio, A, Sesti, G, Andreozzi, F, Frau, G, Boi, A, Solini A., Penno G., Orsi E., Bonora E., Fondelli C., Trevisan R., Vedovato M., Cavalot F., Lamacchia O., Baroni M. G., Nicolucci A., Pugliese G., Bollanti L., Alessi E., Vitale M., Cirrito T., Cavallo-Perin P., Gruden G., Lorenzati B., Trovati M., Di Martino L., Mazzaglia F., Zerbini G., Martina V., Maestroni S., Capuano V., Palmieri E., Lunati E., Grancini V., Resi V., Pontiroli A., Veronelli A., Zecchini B., Arosio M., Montefusco L., Rossi A., Adda G., Corsi A., Albizzi M., Zoppini G., Avogaro A., Pucci L., Lucchesi D., Russo E., Garofolo M., Dotta F., Nigi L., Morano S., Filardi T., Turinese I., Rossetti M., Buzzetti R., Foffi C., Cignarelli M., Pinnelli S., Monaco L., Giorgino F., Laviola L., Natalicchio A., Sesti G., Andreozzi F., Frau G., Boi A., Solini, A, Penno, G, Orsi, E, Bonora, E, Fondelli, C, Trevisan, R, Vedovato, M, Cavalot, F, Lamacchia, O, Baroni, M, Nicolucci, A, Pugliese, G, Bollanti, L, Alessi, E, Vitale, M, Cirrito, T, Cavallo-Perin, P, Gruden, G, Lorenzati, B, Trovati, M, Di Martino, L, Mazzaglia, F, Zerbini, G, Martina, V, Maestroni, S, Capuano, V, Palmieri, E, Lunati, E, Grancini, V, Resi, V, Pontiroli, A, Veronelli, A, Zecchini, B, Arosio, M, Montefusco, L, Rossi, A, Adda, G, Corsi, A, Albizzi, M, Zoppini, G, Avogaro, A, Pucci, L, Lucchesi, D, Russo, E, Garofolo, M, Dotta, F, Nigi, L, Morano, S, Filardi, T, Turinese, I, Rossetti, M, Buzzetti, R, Foffi, C, Cignarelli, M, Pinnelli, S, Monaco, L, Giorgino, F, Laviola, L, Natalicchio, A, Sesti, G, Andreozzi, F, Frau, G, Boi, A, Solini A., Penno G., Orsi E., Bonora E., Fondelli C., Trevisan R., Vedovato M., Cavalot F., Lamacchia O., Baroni M. G., Nicolucci A., Pugliese G., Bollanti L., Alessi E., Vitale M., Cirrito T., Cavallo-Perin P., Gruden G., Lorenzati B., Trovati M., Di Martino L., Mazzaglia F., Zerbini G., Martina V., Maestroni S., Capuano V., Palmieri E., Lunati E., Grancini V., Resi V., Pontiroli A., Veronelli A., Zecchini B., Arosio M., Montefusco L., Rossi A., Adda G., Corsi A., Albizzi M., Zoppini G., Avogaro A., Pucci L., Lucchesi D., Russo E., Garofolo M., Dotta F., Nigi L., Morano S., Filardi T., Turinese I., Rossetti M., Buzzetti R., Foffi C., Cignarelli M., Pinnelli S., Monaco L., Giorgino F., Laviola L., Natalicchio A., Sesti G., Andreozzi F., Frau G., and Boi A.
- Abstract
Background: Resistant hypertension is independently associated with an increased risk of death in the general hypertensive population. We assessed whether resistant hypertension is an independent predictor of all-cause mortality in individuals with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study. Methods: On 31 October 2015, vital status information was retrieved for 15,656 of the 15,773 participants enrolled in 2006-2008. Based on baseline blood pressure (BP) values and treatment, participants were categorized as normotensive, untreated hypertensive, controlled hypertensive (i.e., on-target with < 3 drugs), uncontrolled hypertensive (i.e., not on-target with 1-2 drugs), or resistant hypertensive (i.e., uncontrolled with > 3 drugs or controlled with > 4 drugs). Kaplan-Meier and Cox proportional hazards regression analyses were used to assess the association with all-cause mortality. Results: Using the 130/80 mmHg targets for categorization, crude mortality rates and Kaplan-Meier estimates were highest among resistant hypertension participants, especially those with controlled resistant hypertension. As compared with resistant hypertension, risk for all-cause mortality was significantly lower for all the other groups, including individuals with controlled hypertension (hazard ratio 0.81 [95% confidence interval 0.74-0.89], P < 0.0001), but became progressively similar between resistant and controlled hypertension after adjustment for cardiovascular risk factors and complications/comorbidities. Also when compared with controlled resistant hypertension, mortality risk was significantly lower for all the other groups, including controlled hypertension, even after adjusting for cardiovascular risk factors (0.77 [0.63-0.95], P = 0.012), but not for complications/comorbidities (0.88 [0.72-1.08], P = 0.216). BP was well below target in the controlled hypertensive groups (resistant and non-resistant) and values < 120/7
- Published
- 2019