Choi S-W, Kim M-K, Han S W, Han S H, Lee B K, Lee S U, Hur S-H, Lim S W, Moon K W, Lee S G, Lee S H, Oh S K, Chea J G, Joo S J, Jo M C, Hong K-S, Ryu K-H
Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong, Korea.
Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea.
J Hum Hypertens. 2014 Mar;28(3):201-5. doi: 10.1038/jhh.2013.76. Epub 2013 Aug 29.
The aim of this study was to determine the clinical characteristics of patients with resistant hypertension (RH) and predictors among elderly Korean hypertensives. This prospective, multi-center, observational study evaluated 2439 elderly hypertensive patients between December 2008 and November 2011, who visited secondary hypertension clinics for high blood pressure (BP). Patients were categorized as resistant if their BP was ≥140/90 mm Hg and if they reported using antihypertensive medications from three different drug classes, including a diuretic or drugs from ≥4 antihypertensive drug classes, regardless of BP. Characteristics of patients with RH were compared with those of patients who were controlled with one or two antihypertensive medications after 6-month antihypertensive treatment. In comparison with 837 patients with non-RH, 404 patients with RH were more likely to be aware of their status of high BP before enrollment and have a high baseline systolic BP ≥160 mm Hg, microalbuminuria, high body mass index (BMI) ≥24 kg m(-2) and diabetes mellitus (DM). In drug-naive patients, awareness of hypertension at baseline was the only independent predictor for RH. In elderly Korean hypertensives, BMI (≥24 kg m(-2)), baseline systolic BP (≥160 mm Hg), microalbuminuria, DM and awareness of hypertension showed an association with RH.
本研究旨在确定老年韩国高血压患者中难治性高血压（RH）患者的临床特征及预测因素。这项前瞻性、多中心、观察性研究评估了2008年12月至2011年11月期间因高血压（BP）就诊于二级高血压诊所的2439例老年高血压患者。如果患者的血压≥140/90 mmHg，且报告使用了三种不同药物类别的抗高血压药物，包括利尿剂或≥4种抗高血压药物类别中的药物，无论血压如何，则将其归类为难治性高血压。将RH患者的特征与经过6个月抗高血压治疗后用一种或两种抗高血压药物控制的患者的特征进行比较。与837例非RH患者相比，404例RH患者在入组前更有可能知晓自己的高血压状况，且基线收缩压≥160 mmHg、微量白蛋白尿、高体重指数（BMI）≥24 kg·m⁻²以及患有糖尿病（DM）。在初治患者中，基线时对高血压的知晓是RH的唯一独立预测因素。在老年韩国高血压患者中，BMI（≥24 kg·m⁻²）、基线收缩压（≥160 mmHg）、微量白蛋白尿、DM以及对高血压的知晓与RH相关。
