Lower Death Risk Seen in Resistant Hypertension

(Med Page Today) — Patients with hard-to-treat, resistant hypertension have greater risks of several outcomes, with the exception of all-cause mortality, researchers found.

After accounting for increased rates of various comorbidities, the resistant population still had elevated risks of myocardial infarction (MI), stroke, congestive heart failure, and end-stage renal disease, according to John Sim, MD, of Kaiser Permanente Los Angeles Medical Center.

However, despite having higher unadjusted rates of all-cause mortality through about 3 years of follow-up (13.5% versus 8.3%), patients with resistant hypertension had a lower adjusted risk of death (HR 0.81, 95% CI 95% CI 0.78 to 0.84), Sim reported at the American Society of Hypertension meeting here.

The explanation is unclear, he said, although he and his colleagues are exploring healthcare utilization, medication use, and blood pressure effects as possibilities.

Patients with resistant hypertension are difficult to study because of challenges in identification. There is confounding by pseudoresistant hypertension and differences in sources of data, study populations, and treatment environments.

Nevertheless, previous studies have suggested that those with resistant hypertension suffer from greater target organ damage, increased cardiovascular risk, and possibly greater mortality compared with the general hypertension population.

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