High prevalence of secondary hypertension and insulin resistance in patients with refractory hypertension.
| Autor: | Martell N; Unidad de Hipertension, Hospital Clínico San Carlos, Madrid, Spain. nmartellc@nexo.es, Rodriguez-Cerrillo M, Grobbee DE, López-Eady MD, Fernández-Pinilla C, Avila M, Fernández-Cruz A, Luque M |
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| Jazyk: | angličtina |
| Zdroj: | Blood pressure [Blood Press] 2003; Vol. 12 (3), pp. 149-54. |
| DOI: | 10.1080/08037050310009950 |
| Abstrakt: | Objective: To determine causes of treatment resistance in patients with refractory hypertension, and to estimate the prevalence of true resistant hypertension. Methods: We studied 50 consecutive patients referred with refractory hypertension after exclusion of hypokalemia and stenosis of the renal artery. Ambulatory blood pressure monitoring was performed in all patients to detect white-coat effect. The patients were hospitalized, antihypertensive drugs were withdrawn and a screening for secondary hypertension was performed. In addition, these patients, and a control group of essential hypertensives controlled with three antihypertensive drugs, underwent a OGTT with 75 g of glucose. Results: Primary normokalemic hyperaldosteronism was diagnosed in seven patients. Two patients had a pheochromocytoma and six had white-coat effect. The 35 remaining patients with true resistant hypertension shown significant differences in serum insulin and HOMA IR when compared with the control group. Conclusions: These findings show that among normokalemic treatment-resistant hypertension, the presence of hyperaldosteronism and pheochromocytoma is quite high. Moreover, treatment resistance in hypertensive patients appears to be associated with insulin resistance. |
| Databáze: | MEDLINE |
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