Clinical features of resistant and refractories hypertensives submitted to 24-hour ABPM

Abstract

Ten to twenty percent of patients with hypertension are considered resistant to treatment. Resistant hypertension is one in which the patient cannot be controlled with the use of three drugs at maximum doses, including a diuretic, or when blood pressure (BP) is controlled with the use of four or more anti-hypertensive drugs. Refractory hypertension is an extreme phenotype of resistant hypertension, when the BP cannot be controlled despite the usage of four anti-hypertensives,. PURPOSE- evaluate the clinical profile of resistant and refractory hypertensives by ABPM. METHODS- From January of 2019 to June of 2022, a total of 669 ABPMs were performed at Unicordis., in which three or more drugs were used in the therapy. We divided these patients into three groups: I) patients who achieved BP control with three drugs; II) patients with resistant hypertension III) patients with refractory hypertension . RESULTS- We observed that 317 had their BP controlled with three drugs (47%), 275 patients (41%) were considered to have resistant hypertension, and 77 patients were in the refractory hypertension group (12%). When we divided the number of patients with refractory hypertension(77) by the sum of patients with resistant and refractory SAH (352), we have that refractory hypertension was present in 21% of the total cases of resistant SAH. CONCLUSIONS- Older ages, male gender, and higher BMI were more present in the resistant group than in the control group. Older ages and higher incidence of DM and COPD were more frequent in the refractory group than in the control group.