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Characteristics of patients resistant to antihypertensive drug therapy
Author(s) -
ISAKSSON H.,
DANIELSSON M.,
ROSENHAMER G.,
KONARSKISVENSSON J. C.,
ÖSTERGREN J.
Publication year - 1991
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1991.tb00369.x
Subject(s) - medicine , blood pressure , diabetes mellitus , supine position , antihypertensive drug , body mass index , refractory (planetary science) , diastole , cardiology , endocrinology , physics , astrobiology
. In order to determine the features that characterize refractory hypertension (RH), patients aged < 65 years in a hypertension clinic were screened. Thirty‐six patients on triple drug therapy with a supine diastolic blood pressure (DBP) of ≥ 5 mmHg above an identified target pressure (90–100 mmHg), or a systolic blood pressure (SBP) ≥ 170 mmHg for the last 6 months (≥ 3 measurements) underwent a thorough clinical investigation. The frequency of renal artery stenosis (RAS) in the RH patients was 30%. The non‐RAS patients had a low occupational status, 76% being either manual workers or unskilled non‐manual workers (reference group: 42%: P < 0.01). They were more obese (body mass index (BMI) 28.8 vs. 25.8; P < 0.01), and had a longer duration of hypertensive disease. RH patients had a higher prevalence of non‐insulin‐dependent diabetes mellitus (18 vs. 6%; P < 0.05), and showed a higher prevalence of nervous complaints and mental distress (44% vs. 12%: P < 0.001) and musculo‐skeletal pain (39% vs. 7%; P < 0.001). It is suggested that refractory hypertension should be investigated and treated bearing psychosocial factors in mind, concurrently with a screening for secondary hypertension.