Among patients referred to specialized centers for apparent treatment resistant hypertension in Belgium, the prevalence of true resistant hypertension was estimated at 21.9%, with pseudo-resistant hypertension mainly associated with underuse of triple combination therapy and suboptimal dosing.
Key Findings
Results
The prevalence of true resistant hypertension among patients referred for apparent treatment resistant hypertension was estimated at 21.9%.
95% CI: 14.7%–30.6%
201 eligible patients were included in the cross-sectional survey
About 3 out of 4 patients presented with pseudo-resistant hypertension
Study was a single-visit, multicentric, non-interventional, cross-sectional survey conducted in Belgium
Inclusion criteria required patients over 18 years receiving 3 or more antihypertensive molecules and referred to specialized hospital centers for aTRH
Results
Only 56.7% of patients were treated with the guideline-recommended triple combination therapy.
Guideline-recommended triple combination therapy consists of a renin-angiotensin-aldosterone system inhibitor, calcium channel blocker, and thiazide (-like) diuretic
Half of the participants were polymedicated with non-recommended combinations of antihypertensive molecules
A third of patients were not using a single pill combination
Sample included 201 eligible patients referred to specialized centers
Results
Only 23.4% of patients were treated with the maximally recommended antihypertensive dose.
Inadequate dosing was observed in the majority of patients
Suboptimal dosing was identified as one of the main factors associated with pseudo-resistant hypertension
This finding was based on 201 included patients across multiple centers in Belgium
Results
White coat hypertension (WCH) was present in 8.7% of patients with available ambulatory blood pressure recordings.
WCH was assessed in 115 patients who had available ambulatory blood pressure recordings
WCH occurrence appeared rather limited in this study population
Not all 201 patients had ambulatory blood pressure monitoring data available
Results
Therapeutic adherence was self-reported as poor or moderate by 20% of patients.
80% of patients self-reported good therapeutic adherence
20% reported poor or moderate adherence
Poor adherence appeared rather limited as a contributor to pseudo-resistant hypertension in this cohort
Adherence was assessed by self-report, which may be subject to reporting bias