Resistant hypertension: Prevalence and profile of patients followed in a university ambulatory

Background: Hypertension affects about 36 million Brazilians. It is estimated that 10%-20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events. Objective: To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension. Methods: Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil. Results: A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD +/- 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group. Conclusion: The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown ("pardos") patients in the population studied, and also because the study was performed in a specialized outpatient clinic.