Improvement in All-Cause Mortality With Blood Pressure Control in a Group of US Veterans With Drug-Resistant Hypertension.
Citation: Journal of Clinical Hypertension. 18(1):33-9, 2016 Jan.PMID: 26440866Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hypertension/dt [Drug Therapy] | *Hypertension/mo [Mortality] | *Veterans/sn [Statistics & Numerical Data] | Aged | Antihypertensive Agents/tu [Therapeutic Use] | Blood Pressure Determination/mt [Methods] | Blood Pressure/de [Drug Effects] | Drug Resistance | Female | Follow-Up Studies | Humans | Male | Middle Aged | Proportional Hazards Models | Retrospective Studies | United States/ep [Epidemiology]Year: 2016Local holdings: Available online from MWHC library: 2001 - presentISSN:- 1524-6175
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 26440866 | Available | 26440866 |
Available online from MWHC library: 2001 - present
The current definition of drug-resistant hypertension includes patients with uncontrolled (URH) (taking >3 antihypertensive medications) and controlled hypertension (CRH; blood pressure [BP] <140/90 mm Hg) (taking >4 medications). The authors hypothesized that all-cause mortality is reduced when URH is controlled. Qualified patients followed at the Washington DC VA Medical Center were included. BPs were averaged for each year of follow-up. In 2006, among 2906 patients who met the criteria for drug-resistant hypertension, 628 had URH. During follow-up, 234 patients were controlled (group 1) and 394 patients remained uncontrolled (group 2). The mortality rate among patients with URH was 28% (110 of 394) and among patients with CRH was 13% (30 of 234), a 54% reduction (P<.01). Multivariate analysis identified independent predictors of mortality as uncontrolled HTN (hazard ratio, 2.5; 95% confidence interval, 1.67-3.75; P<.01), age (hazard ratio, 1.03; 95% confidence interval, 1.01-1.04; P<.01), and diabetes (hazard ratio, 1.46; 95% confidence interval, 1.04-2.05; P<.027). The authors conclude that controlling drug-resistant hypertension markedly reduces all-cause mortality. Copyright © 2015 Wiley Periodicals, Inc.
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