Prevalence and determinants of resistant hypertension in a sample of patients followed in Italian hypertension centers: results from the MINISAL-SIIA study program

• DOI: 10.1038/jhh.2016.6
• Publication Date: 2016-03-03T10:21:00Z
• Authors: F Galletti; A Barbato; ; F Galletti; S Modesti; C Pascale; A Bosio; F Cerrato; O Pallisco; C Massara; F Veglio; F Rabbia; E Testa; N Musso; A Artom; M Castellano; I Pirola; G Parati; LM Lonati; C Cuspidi; C Sala; M Rescaldani; A Morganti; B Gidaro; A Grandi; C Lonati; A M Maresca; L Merletti; G Garavelliv; C Pini; M Crippa; F Lazzari; E Ronchi; G Gaudio; F Fallo; L A Calò; P Caielli; G Rossi; L A Sechi; L Marzano; C Catena; G Bernini; A Ungar; R Giovannetti; F Cipollini; E Arcangeli; P Borgheresi; V Panichi; E Rossi; C Borghi; M Veronesi; A Biggi; L Musiari; A Montanari; A Caiazza; M Meschi; R Sarzaniv; G Giacchetti; G Schillaci; G Pucci; C Ferri; A Mezzetti; G Desideri; L Iacoviello; N De Luca; A Barbato; M Manfredi; G Rossi; V Fazio; M D’Avino; M Guglielmi; P Nazzaro; G A De Giorgi; A Del Giudice; A Belfiore; M Barbiero; A Nardecchia; G De Pergola; F Silvestris; L Vinella; F Mallamaci; D Leonardis; L Malatino; B Stancanelli; C Cilia
• Keywords: Male; Time Factors; Time Factor; Drug Resistance; Blood Pressure; Antihypertensive Agents; Blood Pressure; Cross-Sectional Studies; Female; Humans; Hypertension; Italy; Male; Middle Aged; Prevalence; Risk Factors; Time Factors; Treatment Outcome; Drug Resistance; Risk Reduction Behavior; Internal Medicine; 03 medical and health sciences; 0302 clinical medicine; hypertension; sodium intake; sodium excretion; Risk Factors; Internal Medicine; Prevalence; Humans; Antihypertensive Agents; Cross-Sectional Studie; Risk Factor; resistant hypertension, salt, MINISAL; Middle Aged; 16. Peace & justice; 3. Good health; Antihypertensive Agent; Cross-Sectional Studies; Treatment Outcome; Italy; Hypertension; Female; Risk Reduction Behavior; Human

The aim of this study was to detect the prevalence of resistant hypertension (RH), allowing for adherence to appropriate lifestyle measures according to European Society of Hypertension-European Society of Cardiology (ESH-ESC) 2013 guidelines, in a sample of 1284 hypertensive subjects participating at the MINISAL-SIIA study. Hypertensive patients were recruited in 47 Italian centres, recognised by the Italian Society of Hypertension. Anthropometric indexes, blood pressure and 24-h urinary sodium (Na24h) and potassium (K24h) excretion were measured. Data on antihypertensive therapy were available for 1177 (92%) subjects. The population was divided into three groups (North, Central and South), according to their geographical location. Accounting only at the treatment criteria, the prevalence of RH was 8.2% (96/1177). RH prevalence in the southern, central and northern regions was respectively: 1, 3.8 and 3.3% (P<0.001). Participants with RH were older and showed a higher body mass index (BMI) and waist circumference compared with other subjects (P<0.005). RH risk was statistically significant (P<0.01) increased of 1.52-fold (95% confidence interval (CI):1.20-1.92) for one unit increase in s.d. score of age (11 years), and 1.50-fold (95% CI:1.22-1.83) for one unit increase in s.d. score of BMI (4.5 kg m-2). Including in RH diagnosis also the adherence to appropriate lifestyle measures, such as dietary salt restriction (Na24h <100 mmol) and normal BMI (18-25 kg m-2), RH prevalence felt respectively to 2.2% (26/1177) and 0.8% (9/1177). In conclusion in this national sample of Italian hypertensive population, among participants following both drug treatment and lifestyle modifications advises, the 'true' RH prevalence appears to be particularly low.