aClinica Medica, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Monza bIstituto Auxologico Italiano, Ospedale San Luca, Milan, Italy cCenter for Cardiovascular Prevention, Thomayer Hospital and Department of Preventive Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic dPharmacology Department and INSERM U970 Hopital Europeen Georges Pompidou, Assistance-Publique Hopitaux de Paris, Paris-Derscartes University, France eDepartment of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland fInternal Medicine, Hospital Clinico, University of Valencia, Valencia, Spain gIRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
J Hypertens. 2013 Oct;31(10):2018-24. doi: 10.1097/HJH.0b013e328363823f.
Scanty information is available on the clinical characteristics of resistant hypertension in Central and East European countries. The Blood Pressure (BP) control rate and CArdiovascular Risk profilE (BP-CARE) study allowed us to assess the prevalence and the main clinical features of resistant hypertension in this population.
The study was carried out in 1312 treated hypertensive patients living in nine Central and East European countries.
Four hundred and twenty-three patients had apparent resistant hypertension, of whom 168 had pseudo-resistant hypertension (noncompliant/white-coat) and 255 were true treatment-resistant hypertension patients (TRH). Clinical BP values in TRH amounted to 157.4±16.9/91.8±10.0 mmHg despite the daily use of 3.6±0.7 drugs. Their 24-h BP values were 149.5±16.5/97.5±9.8 mmHg. Compared to controlled hypertensive patients (n=368) and uncontrolled nonresistant hypertensive patients (n=521), TRH were older with a greater prevalence of women. They showed a higher rate of previous cardiovascular events and a very high cardiovascular risk profile. Estimated glomerular filtration rate was significantly lower in TRH as compared to controlled hypertensive patients and uncontrolled nonresistant hypertensive patients. Overall, target organ damage was more frequently detected in TRH than in controlled hypertensive patients and uncontrolled nonresistant hypertensive patients. The factor most frequently associated with TRH was severity of hypertension followed by age, total cholesterol, BMI and history of heart failure.
The present study provides evidence that the prevalence of TRH in Central and East European countries is similar to that found in Western Europe and USA. It also shows the very high cardiovascular risk of TRH and the elevated association of this condition with obesity, renal failure, organ damage and history of cardiovascular events.
有关中欧和东欧国家耐药性高血压的临床特征的信息很少。血压（BP）控制率和心血管风险概况（BP-CARE）研究使我们能够评估该人群中耐药性高血压的患病率和主要临床特征。
该研究在居住在九个中欧和东欧国家的 1312 名接受治疗的高血压患者中进行。
423 名患者患有明显的耐药性高血压，其中 168 名患者患有假性耐药性高血压（不依从/白大衣），255 名患者为真正的治疗耐药性高血压患者（TRH）。尽管每天使用 3.6±0.7 种药物，TRH 的临床 BP 值仍为 157.4±16.9/91.8±10.0 mmHg。他们的 24 小时 BP 值为 149.5±16.5/97.5±9.8 mmHg。与血压控制良好的高血压患者（n=368）和未控制的非耐药性高血压患者（n=521）相比，TRH 患者年龄较大，女性患病率较高。他们发生心血管事件的风险更高，心血管风险状况非常高。与血压控制良好的高血压患者和未控制的非耐药性高血压患者相比，TRH 的估算肾小球滤过率明显较低。总的来说，TRH 比血压控制良好的高血压患者和未控制的非耐药性高血压患者更频繁地检测到靶器官损伤。与 TRH 最相关的因素是高血压的严重程度，其次是年龄、总胆固醇、BMI 和心力衰竭病史。
本研究表明，中欧和东欧国家 TRH 的患病率与西欧和美国相似。它还表明，TRH 的心血管风险非常高，并且这种情况与肥胖症、肾衰竭、器官损伤和心血管事件史之间存在很高的关联。
