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True Resistant Hypertension among Treated Hypertensive Black Patients. A Clinical-Based Cross-Sectional Study

机译:治疗的高血压黑人患者中的真正抵抗性高血压。基于临床的横断面研究

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Background and Objective: 24-h ambulatory blood pressure monitoring (ABPM) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates of tRH among patients with clinically suspected RH. Methods: Medical records of treated hypertensive patients referred in four healthcare centers for BP control evaluation by 24-h ABPM were reviewed to assess the prevalence of tRH. Inclusion criteria were age ≥ 18 years, clinical diagnosis of RH. Data on demographic, clinical, laboratory, 2D-echocardiography and 24-h ABPM parameters were retrieved from patient’s medical records. True RH (tRH) was defined as office blood pressure (BP) ≥ 140/90 mmHg and 24-h ambulatory BP ≥ 130/80 mmHg. Simple and multiple linear regression analyses were used to assess factors associated with systolic BP (SBP) as a proxy of RH among patients with tRH. P 0.05 defined the level of statistical significance. Results: Of 636 patients referred for BP control evaluation by 24-h ABPM, 75 (11.7%) had suspected RH by office BP measurements. After 24-h ABPM, pseudo or apparent RH (aRH) and tRH were observed in 15 (2.3%) and 60 (9.4%) patients, respectively. BMI (p = 0.007) and blood glucose (p = 0.024) were positively associated with SBP whereas a negative association was observed with eGFR (p = 0.022) among tRH hypertensive patients in multiple regression analysis. Conclusion: True RH was a common finding among patients with clinical RH and associated with obesity and silent target organ, especially kidney dysfunction. The present study highlights the diagnostic and prognostic importance of 24-h ABPM among patients with clinical RH.
机译:背景和目的:24-h外部血压监测(ABPM)辅助精确识别具有真正抗性高血压(TRH)的患者。本研究旨在评估临床疑似RH患者TRH的频率和相关性。方法:通过24-H ABPM进行24小时BP控制评估的四个医疗保健中心的治疗高血压患者的病程评估TRH的患病率。纳入标准年龄≥18岁,临床诊断RH。从患者的病历中检索有关人口统计学,临床,实验室,2D超声心动图和24-H ABPM参数的数据。真正的rh(trh)定义为办公室血压(bp)≥140/90mmhg和24-h动态bp≥130/80mmhg。简单和多元线性回归分析用于评估与TRH患者中RH的收缩性BP(SBP)相关的因子。 P 0.05定义统计学显着性水平。结果:24-H ABPM提到的636名患者,24-H ABPM,75(11.7%)疑似RH通过办公室BP测量。在24-H ABPM后,分别在15(2.3%)和60(9.4%)患者中观察到伪或明显的RH(ARH)和TRH。 BMI(P = 0.007)和血糖(P = 0.024)与SBP正面相关,而在多元回归分析中,在TRH高血压患者中使用EGFR(P = 0.022)观察阴性关联。结论:True Rh是临床RH患者的常见发现,与肥胖和沉默的靶器官相关,尤其是肾功能紊乱。本研究突出了临床RH患者24-H ABPM的诊断和预后重要性。

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