Usefulness of American College of Cardiology/American Heart Association treatment-resistant hypertension criteria among end-stage kidney disease patients – A case series

Abstract

Context: American College of Cardiology/American Heart Association (ACC/AHA) antihypertensive treatment-resistance criteria have been not used in the hemodialysis (HD) population. Aims: To assess interim Blood Pressure (BP) measures in End-Stage Kidney Disease (ESKD) patients on maintenance hemodialysis after classifying them using the ACC/AHA criteria. Methods: The study was a case series assessing blood pressure readings of ESKD patients undergoing maintenance HD at a tertiary-level care hospital in the United Arab Emirates. Blood pressure readings before, during, and after HD sessions were collected and analyzed. SPSS version 26 was used for data analysis. Results: Out of 55 patients with HD, 10 were classified as having treatment-resistant hypertension, and 6 had controlled hypertension in borderline based on mean post-dialysis Systolic BP (SBP) data of a month. Altogether, the patients underwent 183 dialysis sessions in a month with over 1000 BP readings. The treatment-resistant population showed a p-value less than 0.05 with elevated Pre-SBP, Post-SBP, Mean Intra-SBP, Mean Intra-diastolic BP (DPB), Pre-DBP, Post-DBP, Post-pulse pressure (PP), and Post-mean arterial pressure (MAP). Conclusions: Use of ACC/AHA criteria for treatment-resistant hypertension might guide setting better treatment goals among ESKD patients on maintenance HD.