Prevalence and determinants of resistant hypertension among hypertensive patients attending a cardiology clinic in China: a prospective cross-sectional study

Purpose: To determine occurrence and determinants of resistant hypertension (RHT) among patients attending cardiology clinic of the affiliated hospital of Hangzhou Normal University, China.
Methods: An observational prospective cross-sectional study was conducted among patients with hypertension attending the cardiology clinic over a period of 6 months. After identification of patients with RHT, various independent co-variants were tested by logistic regression in order to evaluate the determinants of RHT.
Results: Out of 556 patients, 104 (18.7 %) patients had RHT while 67 (12.1 %) patients had uncontrolled blood pressure (BP) in spite of treatment with three antihypertensive drugs including a diuretic; 37 (6.6 %) patients had controlled BP with > three drugs. Obesity (OR: 2.7, p = 0.002], duration of hypertension (OR: 1.8, p = 0.015], presence of diabetes mellitus (OR: 3.6, p < 0.001) and ischemic heart disease (OR: 3.2, p = 0.001) were significant determinants of resistant hypertension in the study cohort.
Conclusion: The prevalence of RHT found in this study is significantly high, thus indicating a need for greater attention of clinicians to this highly morbid condition. Obese patients and those suffering from diabetes mellitus, ischemic heart disease and chronic diseases should be evaluated for the presence of RHT. Early identification of such patients will provide sufficient time for clinicians to refer patients, as well as modify and/or intensify therapy.

Keywords
Resistant hypertension; Risk factors; Hypertension; Stroke; Diabetes mellitus; Ischemic heart disease