关键词: obese overweight resistant hypertension

Mesh : Antihypertensive Agents / therapeutic use Blood Pressure / physiology Blood Pressure Determination / methods Body Mass Index Comorbidity Cross-Sectional Studies Diabetes Mellitus / drug therapy epidemiology Drug Resistance / physiology Ethnicity Female Guidelines as Topic Heart Failure, Diastolic / epidemiology Humans Hypertension / epidemiology physiopathology Insulin / therapeutic use Male Middle Aged New York City / epidemiology Obesity / complications epidemiology Overweight Prevalence Renal Insufficiency, Chronic / classification epidemiology Risk Factors

来  源:   DOI:10.1111/jch.13666   PDF(Sci-hub)

Abstract:
Obesity is significantly associated with uncontrolled blood pressure and resistant hypertension (RH). There are limited studies on the prevalence and determinants of RH in patients with higher body mass index (BMI) values. Since the hypertension guidelines changed in 2017, the prevalence of RH has become unknown and now is subject to be estimated by further studies. We conducted a cross-sectional study in an urban Federally Qualified Health Center in New York City aiming to estimate the prevalence of RH in high-risk overweight and obese patients based on the new hypertension definition, BP threshold ≥130/80 mm Hg, and also to describe the associated comorbid conditions in these patients. We identified 761 eligible high-risk overweight and obese subjects with hypertension between October 2017 and October 2018. Apparent treatment-RH was found in 13.6% among the entire study population. This represented 15.4% of those treated with BP-lowering agents. True RH confirmed with out-of-office elevated BP was found in 6.7% of the study population and 7.4% among patients treated with BP-lowering agents. Prevalence was higher with higher BMI values. Those with true RH were more likely to be black, to have diabetes mellitus requiring insulin, chronic kidney disease stage 3 or above and diastolic heart failure. In conclusion, obesity is significantly associated with RH and other significant metabolic comorbid conditions.
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