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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 66 No. 3, 2012.

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UNDERESTIMATED FREQUENCY OF RESISTANT HYPERTENSION IN PREDIALYSIS NONDIABETIC PATIENTS

INGRID PRKAčIN ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
DIANA BALENOVIć ; Department of Internal Medicine, Sisak General Hospital, Sisak, Croatia
PETRA PRKAčIN ; Department of Internal Medicine, Sisak General Hospital, Sisak, Croatia
ANDRIJA JURINA ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
LOVRO ŠANTEK ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
DINO KASUMOVIć ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
GORDANA CAVRIć ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
TOMISLAV BULUM ; Merkur University Hospital, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia

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Abstract

The real prevalence of resistant hypertension (RH) is unknown. Studies suggest that it affects 10%-15% of patients treated for hypertension by primary care physicians. RH is deined as blood pressure (BP) remaining above the goal despite the use of optimal doses of 3 or more medicines of different classes (including a diuretic). It means BP >140/90 mm Hg for the general population and >130/80 mm Hg for patients with diabetes or kidney disease. Prior to diagnosing a patient as having RH, it is important to document medication compliance and exclude white-coat hypertension, inaccurate BP measurement, and secondary causes.
The role of aldosterone in RH has gained increasing recognition. There is strong evidence for the use of spironolactone as a highly effective antihypertensive agent. Aldosterone plays a signiicant role in RH pathogenesis, primarily due to its vasoconstrictive effects and the possibility of altering vascular compliance. In RH, there is a high prevalence of cardiac and extra-cardiac target organ damage. It is known that BP control in chronic kidney disease is the key factor for reducing cardiovascular risk and renal disease progression. The objective of the study was to evaluate the prevalence of RH in predialysis nondiabetic (CKD stage I-IV)
patients.

Keywords

resistant hypertension; predialysis nondiabetic patients

Hrčak ID:

97575

URI

https://hrcak.srce.hr/97575

Publication date:

14.2.2013.

Article data in other languages: croatian

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