Prevalence and determinants of resistant hypertension in a sample of patients followed in Italian hypertension centers: results from the MINISAL-SIIA study program

• Published in: Journal of human hypertension Vol. 30; no. 11; pp. 703 - 708
• Main Authors: Galletti, F, Barbato, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2016; Nature Publishing Group
• Subjects: 692/499; 692/699/75/243; Analysis; Antihypertensive Agents - therapeutic use; Antihypertensives; Blood pressure; Blood Pressure - drug effects; Body mass index; Cross-Sectional Studies; Drug Resistance; Epidemiology; Female; Genetic aspects; Geographical distribution; Health Administration; Humans; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Italy - epidemiology; Lifestyles; Male; Medicine; Medicine & Public Health; Middle Aged; original-article; Patients; Prevalence; Public Health; Risk Factors; Risk Reduction Behavior; Statistical analysis; Time Factors; Treatment Outcome; Italy
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2016.6

The aim of this study was to detect the prevalence of resistant hypertension (RH), allowing for adherence to appropriate lifestyle measures according to European Society of Hypertension-European Society of Cardiology (ESH-ESC) 2013 guidelines, in a sample of 1284 hypertensive subjects participating at the MINISAL-SIIA study. Hypertensive patients were recruited in 47 Italian centres, recognised by the Italian Society of Hypertension. Anthropometric indexes, blood pressure and 24-h urinary sodium (Na24h) and potassium (K24h) excretion were measured. Data on antihypertensive therapy were available for 1177 (92%) subjects. The population was divided into three groups (North, Central and South), according to their geographical location. Accounting only at the treatment criteria, the prevalence of RH was 8.2% (96/1177). RH prevalence in the southern, central and northern regions was respectively: 1, 3.8 and 3.3% ( P <0.001). Participants with RH were older and showed a higher body mass index (BMI) and waist circumference compared with other subjects ( P <0.005). RH risk was statistically significant ( P <0.01) increased of 1.52-fold (95% confidence interval (CI):1.20–1.92) for one unit increase in s.d. score of age (11 years), and 1.50-fold (95% CI:1.22–1.83) for one unit increase in s.d. score of BMI (4.5 kg m − 2 ). Including in RH diagnosis also the adherence to appropriate lifestyle measures, such as dietary salt restriction (Na24h <100 mmol) and normal BMI (18–25 kg m − 2 ), RH prevalence felt respectively to 2.2% (26/1177) and 0.8% (9/1177). In conclusion in this national sample of Italian hypertensive population, among participants following both drug treatment and lifestyle modifications advises, the ‘true’ RH prevalence appears to be particularly low.