# Prevalence, Clinical Characteristics, and Treatment of Patients with Resistant Hypertension: A Single-Center Study

## TL;DR

This study examines the prevalence and characteristics of resistant hypertension and finds that it is linked to higher cardiovascular risk and benefits from optimized treatment.

## Contribution

The study provides insights into the clinical profile and treatment of resistant hypertension in a single-center setting.

## Key findings

- Resistant hypertension affected 3.4% of hypertensive patients and was associated with higher cardiovascular risk.
- Chronic kidney disease, obesity, and stage III hypertension were the strongest predictors of resistant hypertension.
- Single-pill combinations were linked to better blood pressure control in resistant hypertension patients.

## Abstract

Background: Resistant hypertension (HTN) is associated with a high risk of cardiovascular complications. Our study aimed to assess the prevalence, characteristics, and treatment of patients with resistant HTN. Methods: We screened 4340 consecutive cardiovascular patients hospitalized in our clinic and identified 3762 with HTN. Of them, 128 fulfilled criteria for resistant HTN and were included in our study. We matched these patients to 128 hospitalized patients with controlled HTN. Results: Resistant HTN patients comprised 3.4% of all hypertensive individuals. Most of these patients (67.2%) were at high or very high cardiovascular risk compared to controlled HTN patients (40.6%); p < 0001. Resistant HTN patients more commonly had concomitant chronic kidney disease (CKD) (60.9%), overweight/obesity (52.3%), dyslipidemias (35.2%), smoking (27.3%), and diabetes (21.9%) compared to controlled HTN patients (37.5%, 29.7%, 28.1%, 14.1%, and 7.8%, respectively); p < 0.001. Regression analysis showed the strongest association of resistant HTN with CKD (OR 6.64), stage III HTN (OR 3.07), and obesity/overweight (OR 2.60). In contrast, single-pill combinations (SPCs) were associated with a lower likelihood of uncontrolled HTN (OR 0.58). Conclusions: Resistant HTN represented a small proportion of all hypertensives in our study, but it was characterized by high/very high cardiovascular risk. Optimized therapy including increased use of SPCs could improve blood pressure control and long-term prognosis for these patients.