The Prevalence and the Prognosis of Resistant Hypertension Ascertained With Systemic Investigation and Optimal Treatment With Antihypertensive Drugs
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 9,638
- 试验地点
- 18
- 主要终点
- Acute myocardial infarction
研究概览
简要总结
Hypertension is still one of the major preventable risk factor for cardiovascular as well as cerebrovascular diseases globally, including ischaemic heart disease, heart failure, and renal impairment. Despite knowledge on hypertension and the availability of effective antihypertensive medications have progressed dramatically in recent years, the rate of uncontrolled hypertension ( reached 90%) remains high in China[1]. Among those with uncontrolled hypertension，it has been reported that 8.9% in all individuals with hypertension, and 12.8% in the hypertensive drug-treated population[2] are attributed to resistant hypertension. Resistant hypertension has been defined by AHA as high blood pressure (BP) in spite of appropriate lifestyle interventions and treatment of three or more different types of antihypertensive drugs at optimal dose, including at least one diuretics[3,4] or achieving adequate BP control with optimal doses of 4 or more antihypertensive drugs.
At present, not many specifically designed prospective researches concerning resistant hypertension are available. The prevalence of resistant hypertension is not well established and most knowledge about resistant hypertension derives from cross-sectional analyses and clinical trials. The patients with resistant hypertension have been expected to have server target damage, and worse prognosis than those who are non-resistant, but not well established either in the literature[2].
The purpose of this study is to determine the prevalence of resistant hypertension ascertained with systemic investigation and optimal treatment with antihypertensive drugs in community populations and clinic as well as the prognosis among patients with resistant hypertension compared with those who are non-resistant.
详细描述
Hypertension is still one of the major preventable risk factor for cardiovascular as well as cerebrovascular diseases globally, including ischaemic heart disease, heart failure, and renal impairment. Despite knowledge on hypertension and the availability of effective antihypertensive medications have progressed dramatically in recent years, the rate of uncontrolled hypertension ( reached 90%) remains high in China[1]. Among those with uncontrolled hypertension，it has been reported that 8.9% in all individuals with hypertension, and 12.8% in the hypertensive drug-treated population[2] are attributed to resistant hypertension. Resistant hypertension has been defined by AHA as high blood pressure (BP) in spite of appropriate lifestyle interventions and treatment of three or more different types of antihypertensive drugs at optimal dose, including at least one diuretics[3,4] or achieving adequate BP control with optimal doses of 4 or more antihypertensive drugs.
At present, not many specifically designed prospective researches concerning resistant hypertension are available. The prevalence of resistant hypertension is not well established and most knowledge about resistant hypertension derives from cross-sectional analyses and clinical trials. The patients with resistant hypertension have been expected to have server target damage, and worse prognosis than those who are non-resistant, but not well established either in the literature[2].
The purpose of this study is to determine the prevalence of resistant hypertension ascertained with systemic investigation and optimal treatment with antihypertensive drugs in community populations and clinic as well as the prognosis among patients with resistant hypertension compared with those who are non-resistant.
Subjects：Total 9638 patients with hypertension were recruited on December 31 2015，50% from 5 communities screening, 50% from consecutive clinic hypertensive patients. The expected rate of resistant hypertension is 6% in hypertensive population.
Objectives:
研究设计
- 研究类型
- Observational
- 时间视角
- Prospective
入排标准
- 年龄范围
- 30 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Resistant hypertension,ascertained according to AHA criteria: blood pressure remaining above goal (< 140/90 mm Hg for the general population and < 130/80 mm Hg for patients with diabetes or renal disease) despite using optimal doses of 3 antihypertensive agents of different classes(including a diuretic) for half to one year.
- •controllable hypertension blood pressure can reach 130/80 mm Hg or less in half year by use of optimal dose of less than 3 antihypertensive agents of different classes
- •healthy control
- •Age>50 years old
- •Blood pressure ≤ 120/80 mm Hg( 24-hour blood pressure monitor or home blood pressure measurement at 6-9 am and 5-8pm, twice)
- •No cardiovascular diseases: coronary artery disease(coronary angiography or CTA), cerebrovascular diseases(history, MRI-Lacunar brain stem), Carotid ultrasound
- •No peripheral angiopathy (ABI<0.9 or lower extremity vessels Doppler ultrasound)
- •No major cardiovascular risk factors: Dyslipidemia, Diabetes,Smoking within one year.
排除标准
- •severe hepatic diseases
- •mental diseases
- •systemic diseases
结局指标
主要结局
Acute myocardial infarction
时间窗: 3 years
次要结局
- Stroke(3 years)
研究者
hui rutai
Director
Chinese Academy of Medical Sciences, Fuwai Hospital