An Opportunity to Know About Resistant Hypertension in our Area

Una oportunidad para conocer la hipertensión arterial refractaria en nuestro medio

Rafael Vidal-Péreza Fernando Otero-RaviñabRicardo Besada GestocJosé Ramón González-Juanateya

Blood Pressure Control in Hypertensive Women Aged 65 Years or Older in a Primary Care Setting. MERICAP Study

Rev Esp Cardiol. 2011;64:654-6010.1016/j.rec.2011.05.005

José L. Llisterri, Vivencio Barrios, Alex de la Sierra, Vicente Bertomeu, Carlos Escobar, Diego González-Segura

https://doi.org/10.1016/j.rec.2011.08.010

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To the Editor,

We read with interest the article by Llisterri et al.1 regarding blood pressure control in our primary care setting in hypertensive women older than 65 years. The authors report that there is room for improvement in this regard despite the extensive use of combined therapy (3 or more drugs in 21.7% of the sample) and cite several reasons for the differences observed, including poor metabolic control and abdominal obesity. It is noteworthy that the presence of metabolic syndrome was not associated with poor blood pressure control, despite the great difference in the prevalence of this factor between the groups studied.

Our interest arises from a previous registry (HIPERFRE) on resistant hypertension including 1724 patients and carried out by general practitioners in an area of northwest Galicia.2 Although the study included both sexes (58.4% were women), the analysis of the population of women older than 65 shows entirely reproducible data. The degree of blood pressure control was higher in this cohort (40.8%) than in Llisterri's study, and 13.5% of patients had resistant hypertension. Our attention is focused on this finding because, as is known from related guidelines,3 the exact prevalence of this condition is unknown. Resistant hypertension is defined as poor blood pressure control in patients treated with at least 3 drugs, one of which is a diuretic.

Studies such as Llisterri's1 and the recent CARDIOTENS 20094 provide a good opportunity to have access to data on this relatively frequent condition. Although this information was not reported in either study, the percentage of patients with resistant hypertension (ie, the percentage of those receiving 3 or more antihypertensive drugs and experiencing poor blood pressure control) was surely less than 12.5% in MERICAP. It would be of interest to have an approximate estimate and to know whether resistant hypertension was associated with obesity, diabetes mellitus, and metabolic syndrome, as was seen in HIPERFRE.

Corresponding author: rafavidal@hotmail.com

Bibliography

[1]

Llisterri JL, Barrios V, De la Sierra A, Bertomeu V, Escobar C, González Segura D..

Control de la presión arterial en las mujeres hipertensas de 65 o más años de edad asistidas en atención primaria. Estudio MERICAP..

Rev Esp Cardiol. , (2011), 64 pp. 654-660

http://dx.doi.org/10.1016/j.recesp.2011.04.018 | Medline

[2]

Otero FR, Grigorian LS, Lado ML, Lado AL, Turrado VT, Santos JA, et al..

Asociación entre hipertensión refractaria y riesgo cardiometabólico. Estudio HIPERFRE..

Nefrología. , (2008), 28 pp. 425-432

http://dx.doi.org/10.1053/j.ackd.2008.01.013 | Medline

[3]

Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al..

Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research..

Circulation. , (2008), 117 pp. 510-526

[4]

Cordero A, Bertomeu-Martínez V, Mazón P, Fácila L, Bertomeu-González V, Cosín J, et al..

Factores asociados a la falta de control de la hipertensión arterial en pacientes con y sin enfermedad cardiovascular..

Rev Esp Cardiol. , (2011), 64 pp. 587-593

http://dx.doi.org/10.1016/j.recesp.2011.03.008 | Medline