Falsch-Non-Response bei Hypertonie-Behandlung in der Hausarztpraxis

Abstract

Many hypertensive patients still have elevated blood pressure values despite antihypertensive treatment. However, which patients really do not respond to antihypertensive treatment? 41 primary care patients with treated essential arterial hypertension with office blood pressure > 140/90 mmHg received 24-hour ambulatory blood pressure measurement. The patients were categorized into a group with elevated blood pressure both in office (> or = 140/90 mmHg) and daytime ambulatory blood pressure measurement (> 135/85 mmHg) and into a group with False Non-Response to treatment (office blood pressure > or = 140/90 mmHg but normal daytime mean ambulatory blood pressure < 135/85 mmHg). Patients in the group with False NonResponse were significantly more likely to be female compared to patients with both office and ambulatory hypertension (67% vs. 23%, p = 0.009), whereas diabetes mellitus was a significant predictor of elevated blood pressure both in office and ambulatory measurement (7% vs. 39%, p = 0.033). False-Non-Response is common in primary care patients treated for hypertension. These patients have normal ambulatory BP values despite elevated office BP values. Female gender and absence of diabetes mellitus are significant predictors of False Non-response to antihypertensive treatment.