The Burden of Resistant Hypertension Across the World

Curr Hypertens Rep. 2022 Mar;24(3):55-66. doi: 10.1007/s11906-022-01173-w. Epub 2022 Feb 3.

Abstract

Purpose of review: Resistant hypertension (R-HTN) is related to worse cardiovascular, renal outcomes, and death compared to non R-HTN. We aimed to review the burden of R-HTN across the world, focusing on its prevalence, associated factors and outcomes, and the impact of treatment.

Recent findings: R-HTN prevalence among hypertensive individuals varies around 10-20%, depending on the population and definition applied. R-HTN consistently relates to older age, chronic kidney disease, obesity, and obstructive sleep apnea - which are increasing in prevalence with global population aging. As such, R-HTN prevalence is also expected to rise. Infrequent use of ambulatory blood pressure monitoring to identify at higher risk individuals and poor adherence to treatment are still barriers in the approach of R-HTN. Available evidence suggests that 10-20% of patients with hypertension have R-HTN. However, the prevalence of true R-HTN using contemporaneous standardized definitions is still unknown. Novel strategies to address clinicians, patients and health system barriers to treatment inertia and adherence are fundamental to reduce the burden of R-HTN.

Keywords: Burden of disease; Global health; Resistant hypertension.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Female
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Male
  • Prevalence
  • Renal Insufficiency, Chronic* / epidemiology
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / epidemiology