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Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors

Background: The aim of this study was to assess the prevalence, characteristics, and determinants of apparent treatment-resistant hypertension (aTRH) in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country. Methods: A d...

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Autores principales: Symonides, Bartosz, Lewandowski, Jacek, Marcinkowski, Wojciech, Zawierucha, Jacek, Prystacki, Tomasz, Małyszko, Jolanta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455257/
https://www.ncbi.nlm.nih.gov/pubmed/37629449
http://dx.doi.org/10.3390/jcm12165407
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author Symonides, Bartosz
Lewandowski, Jacek
Marcinkowski, Wojciech
Zawierucha, Jacek
Prystacki, Tomasz
Małyszko, Jolanta
author_facet Symonides, Bartosz
Lewandowski, Jacek
Marcinkowski, Wojciech
Zawierucha, Jacek
Prystacki, Tomasz
Małyszko, Jolanta
author_sort Symonides, Bartosz
collection PubMed
description Background: The aim of this study was to assess the prevalence, characteristics, and determinants of apparent treatment-resistant hypertension (aTRH) in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country. Methods: A database of 5879 patients (mean age 65.2 ± 14.2 years, 60% of males receiving hemodialysis) was obtained from the biggest provider of hemodialysis in the country. Hypertension and aTRH were defined using pre- or/and post-dialysis BP values. Patients with and without aTRH (non-aTRH) were compared. Results: Using pre- and post-dialysis criteria, hypertension was diagnosed in 90.7% and 89.1% of subjects, respectively. According to pre- and post-dialysis blood pressure criteria, aTRH incidences were 40.9% and 38.4%, respectively. The hypertensive patients with aTRH versus non-aTRH were younger, had a higher rate of cardiovascular disease, lower dialysis vintage, shorter time on dialysis, higher eKt/V, higher ultrafiltration, higher pre- and post-dialysis BP and HR, and higher use of antihypertensive drugs. Factors that increase the risk of aTRH according to both pre- and post-dialysis BP criteria were age—OR 0.99 [0.98–0.99] and 0.99 [0.98–0.99], the history of CVD 1.26 [1.08–1.46] and 1.30 [1.12–1.51], and diabetes 1.26 [1.08–1.47] and 1.28 [1.09–1.49], adjusted OR with 95% CI. Conclusions: In the real-life world, as much as 40% of HD patients may have aTRH. In ESKD HD patients, aTRH seems to be multifactorial, influenced by patient-related rather than dialysis-related factors. Various definitions of aTRH preclude easy comparisons between studies.
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spelling pubmed-104552572023-08-26 Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors Symonides, Bartosz Lewandowski, Jacek Marcinkowski, Wojciech Zawierucha, Jacek Prystacki, Tomasz Małyszko, Jolanta J Clin Med Article Background: The aim of this study was to assess the prevalence, characteristics, and determinants of apparent treatment-resistant hypertension (aTRH) in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country. Methods: A database of 5879 patients (mean age 65.2 ± 14.2 years, 60% of males receiving hemodialysis) was obtained from the biggest provider of hemodialysis in the country. Hypertension and aTRH were defined using pre- or/and post-dialysis BP values. Patients with and without aTRH (non-aTRH) were compared. Results: Using pre- and post-dialysis criteria, hypertension was diagnosed in 90.7% and 89.1% of subjects, respectively. According to pre- and post-dialysis blood pressure criteria, aTRH incidences were 40.9% and 38.4%, respectively. The hypertensive patients with aTRH versus non-aTRH were younger, had a higher rate of cardiovascular disease, lower dialysis vintage, shorter time on dialysis, higher eKt/V, higher ultrafiltration, higher pre- and post-dialysis BP and HR, and higher use of antihypertensive drugs. Factors that increase the risk of aTRH according to both pre- and post-dialysis BP criteria were age—OR 0.99 [0.98–0.99] and 0.99 [0.98–0.99], the history of CVD 1.26 [1.08–1.46] and 1.30 [1.12–1.51], and diabetes 1.26 [1.08–1.47] and 1.28 [1.09–1.49], adjusted OR with 95% CI. Conclusions: In the real-life world, as much as 40% of HD patients may have aTRH. In ESKD HD patients, aTRH seems to be multifactorial, influenced by patient-related rather than dialysis-related factors. Various definitions of aTRH preclude easy comparisons between studies. MDPI 2023-08-20 /pmc/articles/PMC10455257/ /pubmed/37629449 http://dx.doi.org/10.3390/jcm12165407 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Symonides, Bartosz
Lewandowski, Jacek
Marcinkowski, Wojciech
Zawierucha, Jacek
Prystacki, Tomasz
Małyszko, Jolanta
Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title_full Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title_fullStr Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title_full_unstemmed Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title_short Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
title_sort apparently resistant hypertension in polish hemodialyzed population: prevalence and risk factors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455257/
https://www.ncbi.nlm.nih.gov/pubmed/37629449
http://dx.doi.org/10.3390/jcm12165407
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