Gijón-Conde Teresa, Graciani Auxiliadora, Banegas José R
Centro de Salud Universitario Cerro del Aire, Dirección Asistencial Noroeste, Majadahonda, Madrid, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Rev Esp Cardiol (Engl Ed). 2014 Apr;67(4):270-6. doi: 10.1016/j.rec.2013.09.027. Epub 2014 Feb 5.
The prevalence of resistant hypertension has recently been reported, but there are no studies on its demography. This study aimed to examine the demography and clinical characteristics of resistant hypertension in a large sample of primary care patients.
A cross-sectional study was performed of all computerized medical records of hypertensive patients in Health Area 6 of Madrid (Spain). Of 63 167 hypertensive patients, we selected 48 744 with prescription of antihypertensive medication; of these, we selected those who met the American Heart Association criteria for resistant hypertension.
A total of 6292 patients had resistant hypertension, representing 9.9% of all hypertensive patients and 12.9% of those treated. A total of 5.5% were < 50 years (8.5% men and 3.2% women) and 24.7% were > 80 years (15.8% men and 31.4% women) (P < .001). In patients < 50 years, resistant hypertension was associated with male sex (odds ratio female/male = 0.006; 95% confidence interval, 0.000-0.042; P < .001), systolic blood pressure, obesity, stroke, and chronic kidney disease (P < .001). In those > 80 years, resistant hypertension was associated with female sex (odds ratio female/male = 1.27; 95% confidence interval, 1.08-1,10; P = .004), systolic blood pressure, diabetes mellitus, obesity, chronic kidney disease, coronary heart disease, and atrial fibrillation (P < .001). More than 50% of patients > 80 years with resistant hypertension had cardiovascular disease.
One in 4 patients with resistant hypertension is > 80 years. Resistant hypertension is associated with cardiovascular disease, age < 50 years in men and age > 80 years in women. There is a high proportion of cardiovascular disease in elderly patients with resistant hypertension.
近期已有关于顽固性高血压患病率的报道，但尚无关于其人口统计学特征的研究。本研究旨在调查大量基层医疗患者中顽固性高血压的人口统计学特征和临床特点。
对西班牙马德里第6健康区高血压患者的所有电子病历进行横断面研究。在63167例高血压患者中，我们选取了48744例开具了抗高血压药物处方的患者；其中，我们选取了符合美国心脏协会顽固性高血压标准的患者。
共有6292例患者患有顽固性高血压，占所有高血压患者的9.9%，占接受治疗患者的12.9%。共有5.5%的患者年龄小于50岁（男性8.5%，女性3.2%），24.7%的患者年龄大于80岁（男性15.8%，女性31.4%）（P<0.001）。在年龄小于50岁的患者中，顽固性高血压与男性性别、收缩压、肥胖、中风和慢性肾病相关（P<0.001）。在年龄大于80岁的患者中，顽固性高血压与女性性别、收缩压、糖尿病、肥胖、慢性肾病、冠心病和心房颤动相关（P<0.001）。年龄大于80岁的顽固性高血压患者中，超过50%患有心血管疾病。
四分之一的顽固性高血压患者年龄大于80岁。顽固性高血压与心血管疾病相关，男性年龄小于50岁，女性年龄大于80岁。老年顽固性高血压患者中心血管疾病的比例较高。
