Prevalence of Apparent Treatment-Resistant Hypertension in ESKD Patients Receiving Peritoneal Dialysis.
Am J Hypertens
; 35(11): 918-922, 2022 11 02.
Article
em En
| MEDLINE
| ID: mdl-35882382
ABSTRACT
BACKGROUND:
Apparent treatment-resistant hypertension (aTRH) is defined as failure to achieve adequate blood pressure (BP) control despite taking ≥3 antihypertensive medications from different categories or when taking ≥4 antihypertensives regardless of BP levels.METHODS:
In this cross-sectional study, we estimated the prevalence of aTRH in 140 patients receiving long-term peritoneal dialysis (PD) in four centers of Northern Greece, using the "gold-standard" method of ambulatory BP monitoring for the assessment of BP control status. The presence of subclinical overhydration was evaluated with the method of bioimpedance spectroscopy (BIS).RESULTS:
Incorporating the diagnostic threshold of 130/80 mmHg for 24-hour ambulatory BP, the prevalence of aTRH in the overall study population was 30%. Compared to patients without aTRH, those with aTRH tended to be older in age, had higher PD vintage, had higher dialysate-to-plasma creatinine ratio, had more commonly history of diabetes mellitus, and were more commonly current smokers. With respect to the volume status, the overhydration index in BIS was higher in those with versus without aTRH (2.0â ±â 1.9 L vs. 1.1â ±â 2.0 L, Pâ <â 0.05). The prevalence of volume overload, defined as an overhydration index in BISâ >â 2.5 L, was also higher in the subgroup of patients with aTRH (38.1% vs. 18.4, Pâ =â 0.01).CONCLUSION:
The present study showed that among patients on PD, the prevalence of aTRH was 30%. However, 38% of PD patients with aTRH had subclinical overhydration in BIS, suggesting that the achievement of adequate volume control may be a therapeutic opportunity to improve the management of hypertension in this high-risk patient population.The present study showed that among patients on PD, the prevalence of aTRH was 30%. However, 38% of PD patients with aTRH had subclinical overhydration in BIS, suggesting that the achievement of adequate volume control may be a therapeutic opportunity to improve the management of hypertension in this high-risk patient population. CLINICAL TRIALS REGISTRATION Trial Number NCT03607747.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diálise Peritoneal
/
Hipertensão
Tipo de estudo:
Observational_studies
/
Prevalence_studies
Limite:
Humans
Idioma:
En
Revista:
Am J Hypertens
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Grécia