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The prevalence and prognosis of resistant hypertension in patients with heart failure.
- Source :
-
PloS one [PLoS One] 2014 Dec 09; Vol. 9 (12), pp. e114958. Date of Electronic Publication: 2014 Dec 09 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Background: Resistant hypertension is associated with adverse clinical outcome in hypertensive patients. However, the prognostic significance of resistant hypertension in patients with heart failure remains uncertain.<br />Methods and Results: The 1 year survival and heart failure re-hospitalization rate of 1288 consecutive patients admitted to a university hospital for either newly diagnosed heart failure or an exacerbation of prior chronic heart failure was analyzed. Resistant hypertension was defined as uncontrolled blood pressure (> 140/90 mmHg) despite being compliant with an antihypertensive regimen that includes 3 or more drugs (including a diuretic). A total of 176 (13.7%) heart failure patients had resistant hypertension. There was no difference in all cause mortality, cardiovascular mortality, and heart failure related re-hospitalization between patients with versus without resistant hypertension. Diabetes [hazard ratio = 1.62, 95% confidence interval = 1.13-2.34; P = 0.010] and serum sodium > 139 mmol/L (hazard ratio = 1.54, 95% confidence interval = 1.06-2.23; P = 0.024) were independently associated with resistant hypertension. Patients with resistant hypertension had a relatively higher survival rate (86.9% vs. 83.8%), although the difference was not significant (log-rank x2 = 1.00, P = 0.317). In patients with reduced ejection fraction, heart failure related re-hospitalization was significantly lower in patients with resistant hypertension (45.8% vs. 59.1%, P = 0.050).<br />Conclusions: Resistant hypertension appears to be not associated with adverse clinical outcome in patients with heart failure, in fact may be a protective factor for reduced heart failure related re-hospitalization in patients with reduced ejection fraction.
- Subjects :
- Adult
Aged
Aged, 80 and over
Blood Pressure drug effects
China epidemiology
Female
Follow-Up Studies
Heart Rate
Humans
Hypertension drug therapy
Male
Middle Aged
Prevalence
Prognosis
Prospective Studies
Stroke Volume
Survival Rate
Antihypertensive Agents administration & dosage
Heart Failure physiopathology
Hospitalization statistics & numerical data
Hypertension epidemiology
Hypertension mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 9
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 25490405
- Full Text :
- https://doi.org/10.1371/journal.pone.0114958