| Abstract [eng] |
Background Resistant hypertension is one of the most complex forms of arterial hypertension and is strongly linked to other cardiovascular risk factors and poor patient survival. Therefore, studies need to determine true prevalence of resistant hypertension and associated cardiovascular risk factors to develop targeted diagnostic and treatment strategies. Aim of the Study To evaluate the prevalence of apparent resistant hypertension in Lithuania and determine its associations with other cardiovascular risk factors and hypertension control. Methods Data was collected from Lithuanian men (n= 13,393) and women (n= 36,053) who participated in the national prevention program from 2009 to 2022. Blood pressure measurements were taken and the prevalence of major cardiovascular risk factors (diabetes mellitus, dyslipidaemia, metabolic syndrome, obesity, smoking, poor nutrition and physical inactivity) was evaluated. The treated hypertension group included individuals diagnosed with hypertension and prescribed treatment. Patients in the apparent resistant hypertension group were diagnosed with primary hypertension and failed to reach the target blood pressure <140/90 mmHg despite treatment with ≥3 antihypertensive drugs (including a thiazide diuretic) or were successfully treated with four or more medications. Results The prevalence of apparent resistant hypertension among men was 11,7% and among women 14,4% of the total treated hypertensive population. The prevalence of apparent resistant hypertension in both sexes decreased during the 2009–2022 period. In women with apparent resistant hypertension, the prevalence of other cardiovascular risk factors such as diabetes mellitus (25.1% vs. 16%, p<0.05), metabolic syndrome (78.7% vs. 67%, p<0.05), poor nutrition (62.6% vs. 58.1%, p<0.05), obesity (71% vs. 51.7%, p<0.05), and physical inactivity (60% vs. 56.1%, p<0.05) was higher compared to the treated hypertension group. Men with apparent resistant hypertension had a significantly higher prevalence of diabetes mellitus (25.9% vs. 18.5%, p<0.001), metabolic syndrome (75.3% vs. 66.3%, 4 p<0.001), poor nutrition (74.9% vs. 68.3%, p<0.001), and physical inactivity (63.6% vs. 55.9%, p<0.001). The rate of successful hypertension control was significantly lower in the apparent resistant hypertension group compared to the treated hypertension group (7.57% vs. 28.4%, p<0.001). Controlled hypertension group had lower prevalence of smoking (30.4% vs. 36%, p<0.001), obesity (40.8% vs. 52.1%, p<0.001), physical inactivity (53.4% vs. 57.8%, p<0.001) and poor nutrition (63.2% vs. 71%, p<0.001) compared with uncontrolled group. Conclusions The prevalence of apparent resistant hypertension in both men and women did not exceed one-sixth of the treated hypertension population. Most cardiovascular risk factors were more common in the apparent resistant hypertension group compared to those with treated hypertension. |
