New Study Reveals Surprising Findings on Resistant Hypertension and Uncovers a Powerful Medication for Stubborn High Blood Pressure
Medication is often prescribed to manage hypertension, a condition characterized by elevated blood pressure that can lead to serious health issues such as stroke or heart attack. However, there are cases where the prescribed medication fails to effectively control the condition. This condition is known as apparent resistant hypertension (aRH), and it necessitates the use of additional medications and medical supervision.
In a recent study published in the peer-reviewed journal Hypertension, researchers from the Smidt Heart Institute at Cedars-Sinai conducted novel research on aRH. Their findings revealed that the prevalence of aRH in a real-world sample was lower than previously reported but still relatively common, affecting almost 1 in 10 patients with hypertension.
During their analysis, the investigators also discovered that patients who effectively managed their aRH were more likely to receive treatment with a commonly used medication called mineralocorticoid receptor antagonist (MRA). MRA treatments were administered to 34% of patients with controlled aRH, whereas only 11% of patients with uncontrolled aRH received such treatment.
Dr. Joseph Ebinger, the corresponding author of the study and an assistant professor of Cardiology at the Smidt Heart Institute, emphasized the higher prevalence of apparent resistant hypertension, stating, “Apparent resistant hypertension is more common than many would anticipate.”
He further noted that within this high-risk patient population, there were significant variations in the treatment approaches employed by healthcare providers, highlighting the need for standardization of care.
The study findings were based on a unique research design that utilized data from the electronic health records of three large healthcare organizations, representing diverse geographical locations. Out of the 2,420,468 patients included in the analysis, 55% were diagnosed with hypertension. Among these hypertensive patients, 8.5% (113,992 individuals) met the criteria for apparent resistant hypertension (aRH).
According to Dr. Ebinger, treating aRH can be as challenging as diagnosing it. The term “apparent” in apparent resistant hypertension indicates that medical professionals must first rule out other potential causes of high blood pressure before confirming the diagnosis. These causes may include medication non-adherence, inappropriate medication selection, or the occurrence of artificially elevated blood pressure in the doctor’s office, known as “white coat hypertension.”
“Large amounts of data tell us that patients with aRH, compared to those with non-resistant forms of hypertension, are at greatest risk for adverse cardiovascular events,” added Ebinger, director of Clinical Analytics in the Smidt Heart Institute. “Identifying these patients and possible causes for their elevated blood pressure is increasingly important.”
Dr. Ebinger stresses the importance of awareness among both medical professionals and patients. Healthcare providers should be mindful that if a patient requires four or more antihypertensive medications to control their blood pressure, it is essential to evaluate alternative causes of hypertension or refer the patient to a specialist.
Similarly, patients should actively engage with their healthcare providers to navigate the complexities of the disease. This includes discussing strategies for medication adherence and addressing potential treatment side effects.
The expertise of Cedars-Sinai’s Smidt Heart Institute lies in treating patients with complex cardiac conditions like aRH. The institute was recently granted the American Heart Association’s Comprehensive Hypertension Center Certification, recognizing its commitment to evidence-based treatment guidelines for people with complex or challenging-to-treat hypertension.
Source: 10.1161/HYPERTENSIONAHA.123.20894
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