Frecuencia de hipertensión arterial resistente en pacientes atendidos en establecimientos de una red asistencial en Perú

Introduction: Resistant arterial hypertension (RHTN) is defined as blood pressure (BP) that remains above the goal, in patients in whom taking three or more antihypertensive drugs has been confirmed. There is variability in the methodology and results of studies on the estimated prevalence of RHTN. Objective: To determine the frequency of RHTN in a healthcare network in Peru and its association with risk factors. Materials and method: 146 patients with essential hypertension were studied. Weight, height, waist circumference, blood pressure (BP), lipid profile, glucose, creatinine, microalbuminuria, echocardiography were evaluated; adherence was assessed with the Morinsky-Green test and the risk of sleep apnea with the Berlin test. In patients with inadequate BP control, treatment was optimized until goals were achieved or treatment with three antihypertensives at optimal doses was reached. Ambulatory BP monitoring (ABPM) was performed to confirm the diagnosis of RHTN. Results: 8.3% (11 patients) met the RHTN criteria and their clinical characteristics were as follows: seven (63.7%) had a non-dipper circadianpattern on ABPM. Eleven (100%) had high cardiovascular risk, nine (81.8%) had metabolic syndrome, nine (81.8%) had a high risk of sleep apnea, and six (54.5%) had left ventricular hypertrophy. The multivariate logistic regression analysis only found a relationship between RHTN and the circadian BP pattern (OR: 2.91; 95% CI: 1.2-7.07; p = 0.018). Conclusions: The prevalence of RHTN was 8.3%. A relationship was only found between RHTN and non-dipper circadian behavior.