Background and objective: The aim of this study was to analyse the clustering of cardiovascular risk factors and the prevalence of metabolic syndrome (MS) in this sample of subjects with resistant hypertension (RH).
Patients and method: One hundred and fifteen subjects with RH were sequentially included. RH was defined as a level of office blood pressure (BP)>or=140/90 mmHg in subjects treated with at least 3 antihypertensive drugs (one of them a diuretic) during at least 2 months and with good compliance. The usual protocol of the Hypertension Unit and ambulatory BP monitoring during 24 h was applied on all the subjects, and an echocardiogram with Doppler was performed on 68 of them. Subjects with a daytime BP>or=135/85 mmHg were defined as pseudoresistant hypertensive.
Results: The mean age (standard deviation) was 61 (10) years, and 50 patients (44%) were males. The mean office BP was 166/95 (16/9) mmHg. The daytime BP was 141/83 (15/12) mmHg. Out of the patients, 88 (76.5%) had a family history of cardiovascular disease; 64 (56%) of obesity; 43 (37%) of hypercholesterolemia; 34 (30%) of low high-density lipoprotein cholesterol; 32 (28%) of diabetes mellitus; and 63 (55%) were sedentary. The prevalence of MS was 54%; target organ damage was found in 70 cases (61%), and 44 (38%) had other associated clinical conditions. Out of the subjects with echocardiography, 49 (72%) presented left ventricular hypertrophy. Pseudoresistant hypertension was found in 31 (27%). There were no significant differences in clinical variables between subjects with RH or psudoresistant hypertension.
Conclusions: Patients with RH had high cardiovascular risk, independent of a good control of ambulatory BP, because of the high prevalence of cardiovascular risk factors and MS. An optimal antihypertensive treatment including specific programs for the control of obesity and a sedentary lifestyle are necessary in the management of these patients.