Cinza-Sanjurjo S, Alonso-Moreno F J, Prieto-Díaz M Á, Divisón-Garrote J A, Rodríguez-Roca G C, Llisterri-Caro J L
Centro de Salud de Porto do Son, Porto do Son, A Coruña, España.
Centro de Salud de Sillería, Toledo, España.
Semergen. 2015 Apr;41(3):123-30. doi: 10.1016/j.semerg.2014.02.014. Epub 2014 Apr 24.
To determine the prevalence and clinical and epidemiological characteristics of Primary Care patients with resistant hypertension (RHT) in Spain.
A cross-sectional multicenter study was conducted on hypertensive patients aged 18 or over and seen in a Primary Care clinic. RHT was considered as the presence of uncontrolled blood pressure in patients treated with at least 3 drugs, one of which is a diuretic.
Of the 12,961 hypertensive patients in the PRESCAP 2010 study, 962 (7.4%) fulfilled criteria for RHT, of whom 51% were women, and with a mean age (SD) 68.8 [11.4] years. Patients with RHT were older (68.80 [10.69] years vs. 66.06 [11.44] years, P<.001), had a higher prevalence of obesity (55.2 vs. 38.6%, P<.001), a higher waist circumference (103.90 [13.89] vs. 99.32 [13.69] cm, P<.001), and a higher prevalence of DM (48.3 vs. 29.5%, P<.001). The prevalence of target organ damage (73.0 vs. 61.4%, P<.001) and cardiovascular disease (46.7 vs. 26.8%, P<.001) were higher in patients with resistant hypertension. The multivariate analysis showed that the variables associated with resistant hypertension were the presence of cardiovascular disease, diabetes mellitus, sedentary life style, microalbuminuria, body mass index, duration of AHT, and triglycerides.
The prevalence of RHT in Primary Care patients is related to inappropriate lifestyles, the presence of target organ damage, and cardiovascular disease.
确定西班牙基层医疗中难治性高血压（RHT）患者的患病率以及临床和流行病学特征。
对年龄在18岁及以上且在基层医疗诊所就诊的高血压患者进行了一项横断面多中心研究。难治性高血压被定义为使用至少3种药物治疗且血压仍未得到控制的患者，其中一种药物为利尿剂。
在PRESCAP 2010研究的12961例高血压患者中，962例（7.4%）符合难治性高血压标准，其中51%为女性，平均年龄（标准差）为68.8[11.4]岁。难治性高血压患者年龄更大（68.80[10.69]岁对66.06[11.44]岁，P<0.001），肥胖患病率更高（55.2%对38.6%，P<0.001），腰围更大（103.90[13.89]对99.32[13.69]cm，P<0.001），糖尿病患病率更高（48.3%对29.5%，P<0.001）。难治性高血压患者靶器官损害（73.0%对61.4%，P<0.001）和心血管疾病（46.7%对26.8%，P<0.001）的患病率更高。多变量分析显示，与难治性高血压相关的变量包括心血管疾病、糖尿病、久坐生活方式、微量白蛋白尿、体重指数、高血压病程和甘油三酯。
基层医疗患者中难治性高血压的患病率与不良生活方式、靶器官损害和心血管疾病的存在有关。
