RESISTANT HYPERTENSION WITH MISPERCEIVED HEART FAILURE: A HIDDEN DRIVER OF HEALTHCARE UTILIZATION

Introduction: Heart failure (HF) risk stratification can lead to misinterpretations, particularly in individuals perceived as being at risk. Patients without structural heart disease but with HF risk factors may perceive themselves as already having the disease, potentially resulting in health anxiety. This study aimed to evaluate the clinical consequences of such misperceptions in patients with resistant hypertension (HT) who believed they had HF despite lacking a formal diagnosis. Methods: This retrospective observational study included patients aged ≥18 years who presented to the emergency department between June 1, 2023, and July 31, 2024. Group 1 consisted of 248 individuals with resistant HT, preserved ejection fraction (EF ≥50%), and no HF diagnosis, yet who believed themselves to have HF. Group 2 included 47 patients with systolic HF (EF ≤40%) receiving sacubitril/valsartan therapy. Emergency department (ED) admissions frequency and 24-hour ambulatory blood pressure monitoring (ABPM) data were compared between groups. Results: Annual ED admissions were significantly higher in Group 1 (p <0.001), and nocturnal ABPM values were higher for both systolic and diastolic blood pressure (p = 0.009 and p = 0.046). No hospitalizations occurred in Group 1, while 25.5% of Group 2 patients were hospitalized. The younger age, preserved oxygen saturation, and normal heart function in Group 1 suggest that ED visits may be psychological rather than physiological in origin. Conclusion: Misinterpreting the risk associated with HF can lead to increased healthcare utilization and elevated blood pressure in patients with resistant HT. Effective communication and psychological support are essential.