Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Patients with resistant hypertension have more peripheral arterial disease than other uncontrolled hypertensives

Journal of Human Hypertension volume 29, pages 46–49 (2015)Cite this article

Subjects

Abstract

The aim of this study was to investigate whether resistant hypertension differs from uncontrolled and controlled hypertension in terms of target organ damage. Hypertensive subjects with antihypertensive medication (n=385) were identified in a population survey conducted in southwestern Finland. None of the study subjects had previously diagnosed cardiovascular or renal disease or diabetes. Ankle-brachial index, estimated glomerular filtration rate, electrocardiogram-determined left ventricular hypertrophy and cardiometabolic risk factors were assessed. The prevalence of peripheral arterial disease among subjects with resistant, uncontrolled and controlled hypertension was 6/37 (16%), 22/275 (8%) and 0/73 (0%), respectively (P=0.006). There were no differences in the prevalence of renal insufficiency, left ventricular hypertrophy or metabolic parameters between the groups. Resistant hypertension affects vasculature more than uncontrolled hypertension, and thus it can be regarded as a marker of more severe disease.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31: 1281–1357.

    Article  Google Scholar 

  2. Cuspidi C, Macca G, Sampieri L, Michev I, Salerno M, Fusi V et al. High prevalence of cardiac and extracardiac target organ damage in refractory hypertension. J Hypertens 2001; 19: 2063–2070.

    Article  CAS  Google Scholar 

  3. de la Sierra A, Banegas JR, Oliveras A, Gorostidi M, Segura J, de la Cruz JJ et al. Clinical differences between resistant hypertensives and patients treated and controlled with three or less drugs. J Hypertens 2012; 30: 1211–1216.

    Article  CAS  Google Scholar 

  4. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation 2012; 125: 1635–1642.

    Article  Google Scholar 

  5. Persell SD . Prevalence of resistant hypertension in the United States, 2003–2008. Hypertension 2011; 57: 1076–1080.

    Article  CAS  Google Scholar 

  6. Korhonen PE, Syvänen K, Vesalainen RE, Kantola IM, Kautiainen H, Järvenpää S et al. Ankle-brachial index is lower in hypertensive than in normotensive individuals in a cardiovascular risk population. J Hypertens 2009; 27: 2036–2043.

    Article  CAS  Google Scholar 

  7. Espinola-Klein C, Rupprecht HJ, Bickel C, Lackner K, Savvidis S, Messow CM et al. Different calculations of ankle-brachial index and their impact on cardiovascular risk prediction. Circulation 2008; 118: 961–967.

    Article  Google Scholar 

  8. Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro AF, Feldman HI et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604–612.

    Article  Google Scholar 

  9. Sokolow M, Lyon T . The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 1949; 37: 161–186.

    Article  CAS  Google Scholar 

  10. Molloy TJ, Okin PM, Devereux RB, Kligfield P . Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product. J Am Coll Cardiol 1992; 20: 1180–1186.

    Article  CAS  Google Scholar 

  11. Korhonen P, Kivelä S-L, Aarnio P, Kautiainen H, Järvenpää S, Kantola I . Estimating glomerular filtration rate in hypertensive subjects: comparison of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations. Ann Med 2012; 44: 487–493.

    Article  CAS  Google Scholar 

  12. Varis J, Savola H, Vesalainen R, Kantola I . Hypertension treatment in Finland still not optimal. Finn Med J 2008; 40: 3294–3289.

    Google Scholar 

  13. Chobanian AV . Control of hypertension—an important national priority. New Engl J Med 2001; 345: 534–535.

    Article  CAS  Google Scholar 

  14. de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Amario P et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension 2011; 57: 898–902.

    Article  CAS  Google Scholar 

  15. Oliveras A, de la Sierra A . Resistant hypertension: patient characteristics, risk factors, co-morbidities and outcomes. J Hum Hypertens 2014; 28: 213–217.

    Article  CAS  Google Scholar 

  16. De Buyzere ML, Clement DL . Management of hypertension in peripheral arterial disease. Prog Cardiovasc Dis 2008; 50: 238–263.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by the Satakunta Hospital District.

Author information

Authors and Affiliations

  1. Central Satakunta Health Federation of Municipalities, Harjavalta, Finland

    P E Korhonen

  2. Satakunta Hospital District, Pori, Finland

    P E Korhonen

  3. Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland

    P E Korhonen

  4. Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland

    H Kautiainen

  5. Department of General Practice, University of Helsinki, Helsinki, Finland

    H Kautiainen

  6. Department of Medicine, Turku University Hospital, Turku, Finland

    I Kantola

Authors
  1. P E Korhonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Kautiainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I Kantola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P E Korhonen.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Korhonen, P., Kautiainen, H. & Kantola, I. Patients with resistant hypertension have more peripheral arterial disease than other uncontrolled hypertensives. J Hum Hypertens 29, 46–49 (2015). https://doi.org/10.1038/jhh.2014.65

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2014.65

Search

Advanced search

Quick links