Resistant Hypertension Ups Risks of Cardiovascular Events, ESRD
Study of U.S. veterans found that patients with resistant hypertension had 23%, 31%, and 144% higher risk of myocardial infarction, stroke, and end-stage renal disease, respectively.
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NEW ORLEANS—Resistant hypertension (RH) is associated with an increased risk of cardiovascular events and end-stage renal disease (ESRD), but not mortality, according to a study of U.S. veterans enrolled in the Million Veteran Program (MVP) presented at Kidney Week 2017.
Patients with RH had a 23%, 31%, and 144% higher risk of myocardial infarction, stroke, and ESRD, respectively, compared with patients who did not have RH, after adjusting for baseline demographics, comorbid conditions, and estimated glomerular filtration rate.
“Better BP control in patients with RH may alleviate the higher risk of MI and stroke,” the investigators, led by Csaba P. Kovesdy, MD and Adriana M. Hung, MD, at the Memphis and Nashville VA Medical Centers, respectively, concluded.
The study included 27,381 U.S. veterans with RH and a comparison group of 268,520 patients without RH. Both groups had a mean age of 61.6 years. The RH and non-RH groups had a mean BP of 143/81 and 134/79 mm Hg, respectively.
The investigators defined RH as failure to achieve an outpatient blood pressure (BP) below 140/90 mm Hg with 3 antihypertensive drugs (including 1 thiazide diuretic), or success with 4 or more drugs, excluding BP when a pain score was higher than 5, when interfering medications were prescribed, and excluding patients with confounding medical conditions.
The MVP is an initiative from the Department of Veterans Affairs to advance precision medicine and is currently among the world largest biobanks, with more than 600,000 participants from 63 VA hospitals.
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Kovesdy CP, Edwards T, Wilson OD, et al. Clinical characteristics and outcomes associated with resistant hypertension in the VA Million Veteran Program. Data presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31-Nov. 5). Poster TH-PO459.