PREVALENCE AND CHARACTERISTICS OF RESISTANT HYPERTENSION. EHUH 2 STUDY

Objective: To evaluate the prevalence of resistant hypertension (RHT) and identify its specific demographic, clinical, and metabolic characteristics, providing insights into this high-risk subgroup. Design and method: This cross-sectional study was part of the EH–UH 2 survey. Out of 2,021 participants randomly selected from the general adult population, this study involved 1,181 individuals, including 580 treated hypertensive (HT) patients. Participants were classified into three groups: RHT (N=49), uncontrolled non-RHT (N=154), and controlled hypertension (N=377). RHT was defined according to recent guidelines. Results: The prevalence rates of RHT were 6.1%, 10.2%, and 24.1% in the total HT population, treated HT patients, and the subgroup of uncontrolled HT, respectively. There were no gender differences among the three subgroups. Patients with RHT were significantly older than those with controlled HT (64.9 vs. 56.5 years, p<0.05), but the prevalence of RHT was consistent across age groups. RHT patients had a higher prevalence of a positive history of stroke (6.5% vs. 2.5%; p=0.06), myocardial infarction (8.7% vs. 2.1%; p=0.004), atrial fibrillation (8.8% vs. 4.3%; p=0.08), chronic kidney disease (14.5% vs. 6.2%; p>0.05), potential undiagnosed HFpEF (18.3% vs. 6.4% vs. 3.6%; p<0.0001), obesity (52% vs. 30.3%; p<0.0001), and diabetes (46.9% vs. 17.9%; p<0.0001). Salt intake and Na/K ratios were significantly higher in RHT patients than in non-controlled non-RHT and controlled HT patients (10.2 vs. 9.9 vs. 9.0 g/day; 3.06 vs. 3.04 vs. 2.87, respectively). Conclusions: Resistant hypertension is associated with advanced age and higher salt intake. These patients had significantly more cardio-reno-metabolic co-morbidities, which, in addition to uncontrolled hypertension contribute to high global risk. These findings highlight the importance of targeted management strategies to improve outcomes for this high-risk group of patients.