Estimating the Prevalence of Resistant Hypertension among Patients Attending Public Health Care Services in Trinidad

Abstract

Background: The rate of resistant hypertension (RH) in Trinidad is unknown. Several studies have shown that 12% to 30% of patients with hypertension in western countries may have RH. This is the first study to describe RH in Trinidad. RH increases the risk of type 2 diabetes, chronic kidney disease, coronary heart disease, heart failure and stroke. Objective: The aim of the study is to measure the proportion of patients with hypertension who meet the criteria for RH among patients attending primary health care facilities in Trinidad and describe its epidemiological features. Design and methods: We used a cross-sectional study design. Participants were selected using a clustered sampling technique from primary care clinics throughout the island. Data were collected by the administration of a pretested structured questionnaire. Apart from demographics, data was collected on the duration of hypertension and predisposing risk factors, and the presence of chronic kidney disease (CKD) and the metabolic syndrome. Results: Initially 428 patients with hypertension were recruited, however only 391 entered the study of which 64 (16.4%, 95% CI 13- 20.3) met the criteria for RH. RH was found to be more common in patients 61-70 years, females and patients of African descent. Half of the patients classified as resistant hypertensive were obese, both CKD abd the metabolic syndrome were higher in patients with RH compared to non-resistant hypertension. Conclusion: We provide evidence for the first time that the occurrence of RH in patients attending primary health care facilities in Trinidad was 16%. RH in Trinidad patients is associated with overweight/obesity, type 2 diabetes, chronic kidney disease and the metabolic syndrome. (266 words)