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Clinical characteristics of patients with resistant hypertension: the RESIST-POL study

Journal of Human Hypertension volume 27, pages 678–685 (2013)Cite this article

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Abstract

Recent studies indicate that resistant hypertension (RHTN) is present in about 12% of the treated hypertensive population. However, patients with true RHTN (confirmed out of the office) have not been widely studied. We prospectively studied 204 patients (123 male, 81female, mean age 48.4 years, range 19–65 years) with truly RHTN (ambulatory daytime mean blood pressure >135/85 mm Hg). We evaluated the frequency of obstructive sleep apnea (OSA), renal artery stenosis (RAS), primary aldosteronism (PA) and other secondary forms of hypertension (HTN) and conditions. Mild, moderate and severe OSA were present in 55 (27.0%), 38 (18.6%) and 54 (26.5%) patients, respectively. Secondary forms of HTN were diagnosed in 49 patients (24.0%), the most frequent being PA (15.7%) and RAS (5.4%). Metabolic syndrome (MS) was present in 65.7% of patients. Excessive sodium excretion was evident in 33.3% of patients and depression in 36.8% patients. In patients with RHTN, OSA and MS were the most frequent conditions, frequently overlapping with each other and also with PA. Our data indicate that in the vast majority of patients with truly RHTN, at least one of three co-morbidities—OSA, MS and PA—is present. Other conditions, even though less frequent, should also be taken into the consideration.

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Acknowledgements

The study was supported by the Ministry of Science and Higher Education NN 402 190 335.

Author information

Authors and Affiliations

  1. Department of Hypertension, Institute of Cardiology, Warsaw, Poland

    E Florczak, A Prejbisz, E Szwench-Pietrasz, E Warchoł & A Januszewicz

  2. IV Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland

    P Śliwiński & P Bieleń

  3. Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland

    A Klisiewicz

  4. Department of Radiology, Institute of Cardiology, Warsaw, Poland

    I Michałowska

  5. Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland

    M Januszewicz

  6. Institute of Forensic Research, Cracow, Poland

    M Kała

  7. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland

    A Witkowski

  8. Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland

    A Więcek

  9. Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland

    K Narkiewicz

  10. Divisions of Cardiovascular Diseases and Hypertension, Mayo Clinic, Rochester, MN, USA

    V K Somers

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  1. E Florczak
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Correspondence to A Prejbisz.

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Competing interests

EF, AP, ES, AK, IM, EW, AW, and AJ have worked at the center receiving per-patient payment for studies involvement from Ardian-Medtronic. EF, AP, AdW, AnW, KN and AJ have received research grants from the Ministry of Science and Higher Education. VKS has served as a consultant for Johnson and Johnson, Medtronic, ResMed, Respironics, Apnex Medical, Neu Pro, Deshum and Sova Pharmaceuticals. He has received research grants from the Respironics Foundation and National Institutes of Health.

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Florczak, E., Prejbisz, A., Szwench-Pietrasz, E. et al. Clinical characteristics of patients with resistant hypertension: the RESIST-POL study. J Hum Hypertens 27, 678–685 (2013). https://doi.org/10.1038/jhh.2013.32

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