Abstract 15862: Epidemiology and Outcomes of Resistant Hypertension in 5788 Community-Dwelling Older Adults
Background According to the 2008 AHA Scientific Statement entitled “Resistant Hypertension: Diagnosis, Evaluation, and Treatment”, “the prevalence of resistant hypertension (HTN) is unknown” and findings from clinical trials and observational studies suggest its prevalence to be 8% to 30%. However, the prevalence of resistant hypertension and outcomes among community-dwelling older adults remains unknown.
Methods Of the 5788 community-dwelling older adults age ≥65 years in the public-use copy of the Cardiovascular Health Study data obtained from the National Heart, Lung and Blood Institute, 3404 (59%) had HTN (SBP ≥140, DBP≥90 or use of anti-HTN drugs) at baseline during 1989-1990. Based on criteria proposed in the 2008 AHA Scientific Statement, we defined resistant HTN as uncontrolled BP (SBP ≥140 or DBP≥90) despite 3 concurrent anti-HTN drugs or the use of >3 anti-HTN drugs.
Results Patients had a mean (±SD) age of 73 (±6) years; 57% were women; and 16% were African American. Among the 2330 with HTN, 174 had resistant HTN (8%) and 1148 had uncontrolled HTN (49%). Of the 174 with resistant HTN, of these 142 (82%) had uncontrolled BP on 3 drugs and 32 (18%) were on >3 drugs. Unadjusted and age-sex-race-adjusted and multivariable-adjusted associations with incident HF and all-cause mortality are displayed in the Table.
Conclusions Among community-dwelling older adults with HTN, the prevalence of resistant HTN was 8% and likely higher given the high 49% prevalence of uncontrolled HTN. Resistant HTN was associated with a significant increased risk of incident HF but had no significant independent association with all-cause mortality.
- © 2011 by American Heart Association, Inc.