PP.26.16

Abstract

Objective: Albeit the unfold of recent discoveries regarding non-drug therapeutic approaches to resistant hypertension (RH), such as catheter-based renal denervation, its role is getting more boldly defined. The correct diagnosis of true RH remains the foundation towards proper patient selection and palpable benefits. The aim of this study was to evaluate the value of a short hospital admission to accurately identify eligible patients to RD. Design and method: It was carried out a retrospective descriptive cross-sectional study, encompassing RH patients followed in ambulatory regimen, who were hospitalised between January 2009 and December 2014 and actively engaged in a restrict dietary and pharmacological plan. Results: A total of 14 patients and 15 admissions were identified. The average age was 62 years old and 60% were women. The average duration of hospitalisation was 3 days and two RH cases were due to a secondary cause. The patients were using an average of 6 antihypertensives agents (including diuretic), prevailing the central action and calcium channel blockers. All patients had uncontrolled BP in ABPM prior to hospitalisation (24 h BP average was 158/ 108/ 85 mmHg for systolic/ mean/ diastolic, respectively, with 88% hypertensive load). Average cardiac frequency was 71 bpm, pulse pressure was 75 mmHg, and only 20% had a dipper pattern. With the hospital admission, all patients have improved BP values (average pressure at discharge of 135/74 mmHg) and with fewer medication (median of five agents). All patients kept follow-up (median of 4 months after discharge), with an average BP of 160/ 79 mmHg. One patient had a cardiovascular major event (stroke) after hospitalisation. Conclusions: All cases in this study were pseudoRH, with two patients (14%) having a secondary cause identified. The remaining cases were probably consequence of adhesion failure to medication and healthy life habits on an daily basis. These results stress the importance of correct RH recognition in a controlled environment in order to avoid false indications for non pharmacological solutions such as RD.