Abstract 17677: Mortality Risk Associated with Apparent Treatment-Resistant Hypertension Among Women
Background: The extent to which apparent treatment-resistant hypertension (aTRH) is associated with mortality in women is not well-established. We assessed mortality risk associated with aTRH among women with varying underlying CV risk.
Methods: We analyzed data from 3 cohorts of women: Women Take Heart (WTH; women without active CV disease at baseline); Women’s Ischemia Syndrome Evaluation (WISE; women with signs/symptoms of ischemia at baseline); and, the INternational VErapamil SR-trandolapril STudy (INVEST; women with CAD+HTN at baseline). Per cohort, women were categorized into 3 groups: no current/previous HTN; non-resistant HTN (non-rHTN; BP ≥140/90 mmHg on ≤2 drugs or BP <140/90 mmHg on 1-3 drugs); and, aTRH (BP ≥140/90 mmHg on ≥3 drugs or anyone on ≥4 drugs). The primary outcome was all-cause death at 10-year follow-up.
Results: aTRH prevalence ranged from 0.4% in WTH to 31.4% in INVEST. Within each cohort, women with aTRH, compared to those without, were older, more often Black, and more likely to be obese or diabetic. On-treatment BP and 10-year mortality data are summarized in the Table. Combining women from all cohorts together, risk of all-cause death was greater in women with aTRH (adjusted HR 2.1; 95% CI 1.4-3.1) and non-rHTN (adjusted HR 1.6; 95% CI 1.1-2.4) than in women without HTN (Figure).
Conclusions: In women with evidence of ischemic heart disease, aTRH is not uncommon and is associated with a substantial, early and sustained risk of all-cause death. Women are known to be at greater risk than men for developing aTRH, thus early recognition and aggressive management are paramount, especially in those with evidence of underlying CV disease.
Author Disclosures: S.M. Smith: None. T. Huo: None. Y. Gong: None. E.M. Handberg: None. M. Gulati: None. C. Bairey Merz: None. C. Pepine: None. R.M. Cooper-DeHoff: None.
- © 2014 by American Heart Association, Inc.