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Characteristics of resistant hypertension: ageing, body mass index, hyperaldosteronism, cardiac hypertrophy and vascular stiffness

Journal of Human Hypertension volume 25, pages 532–538 (2011)Cite this article

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Abstract

Resistant hypertension (RHTN) includes patients whose blood pressure (BP) is controlled with the use of four or more antihypertensive medications, and is referred to as ‘controlled resistant hypertension’ (CRH). While specifically comparing patients with CRH and uncontrolled resistant hypertension (UCRH), we hoped to identify distinguishing characteristics that would provide insight into factors contributing to resistance to antihypertensive therapies. RHTN patients were identified as controlled (CRH, n=43) or uncontrolled (UCRH, n=47). No statistical differences were observed between the CRH and UCRH subgroups with respect to age and gender. The body mass index, aldosterone–renin ratio and pulse wave velocity (PWV) were significantly higher in UCRH patients. Although both subgroups showed increased cardiac mass, left ventricular mass index was significantly higher in UCRH compared with CRH patients. Multivariate linear regression analysis indicated that PWV was significantly dependent on age in both UCRH and CRH patients; however, the influence of ageing was more pronounced in the former subgroup. Older age, greater vascular stiffness, higher aldosterone levels and greater left ventricular hypertrophy were significantly associated with lack of BP control in patients with RHTN. These findings suggest important possibilities in terms of preventing and better treating RHTN.

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Acknowledgements

This study was supported by FAPESP, SP, Brazil. H Moreno Jr, V Nasser Figueiredo and T Quinaglia were supported by Conselho Nacional de Pesquisa (CNPq) and CAPES (Brazil).

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Authors and Affiliations

  1. Cardiovascular Pharmacology Laboratory, Faculty of Medical Sciences and Clinic Hospital, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil,

    L C Martins, V N Figueiredo, T Quinaglia, L Boer-Martins, C Demacq & H Moreno Jr

  2. Hypertension Clinic, State Medical School at São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil

    J C Yugar-Toledo & J F V Martin

  3. Endocrine Hypertension Research Center and Clinical Center of Research Excellence in Cardiovascular Disease and Metabolic Disorders, University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia

    E Pimenta

  4. Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, AL, USA

    D A Calhoun

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  1. L C Martins
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Correspondence to L C Martins.

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Martins, L., Figueiredo, V., Quinaglia, T. et al. Characteristics of resistant hypertension: ageing, body mass index, hyperaldosteronism, cardiac hypertrophy and vascular stiffness. J Hum Hypertens 25, 532–538 (2011). https://doi.org/10.1038/jhh.2010.95

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