Association of uncontrolled blood pressure in apparent treatment‐resistant hypertension with increased risk of major adverse cardiovascular events plus

George Bakris; Cindy Chen; Alicia K. Campbell; Veronica Ashton; Lloyd Haskell; Mukul Singhal

doi:10.1111/jch.14701

journal article Open Access Jul 17, 2023

Association of uncontrolled blood pressure in apparent treatment‐resistant hypertension with increased risk of major adverse cardiovascular events plus

George Bakris Cindy Chen Alicia K. Campbell Veronica Ashton

Lloyd Haskell Mukul Singhal

The Journal of Clinical Hypertension Vol. 25 No. 8 pp. 737-747 · Wiley

View at Publisher Save 10.1111/jch.14701

Abstract

AbstractPatients with apparent treatment‐resistant hypertension (aTRH) are at increased risk of end‐organ damage and cardiovascular events. Little is known about the effects of blood pressure (BP) control in this population. Using a national claims database integrated with electronic medical records, the authors evaluated the relationships between uncontrolled BP (UBP; ≥130/80 mmHg) or controlled BP (CBP; <130/80 mmHg) and risk of major adverse cardiovascular events plus (MACE+; stroke, myocardial infarction, heart failure requiring hospitalization) and end‐stage renal disease (ESRD) in adult patients with aTRH (taking ≥3 antihypertensive medication classes concurrently within 30 days between January 1, 2015 and June 30, 2021). MACE+ components were also evaluated separately. Multivariable regression models were used to adjust for baseline differences in demographic and clinical characteristics, and sensitivity analyses using CBP <140/90 mmHg were conducted. Patients with UBP (n = 22 333) were younger and had fewer comorbidities at baseline than those with CBP (n = 11 427). In the primary analysis, which adjusted for these baseline differences, UBP versus CBP patients were at an 8% increased risk of MACE+ (driven by a 31% increased risk of stroke) and a 53% increased risk of ESRD after 2.7 years of follow‐up. Greater MACE+ (22%) and ESRD (98%) risk increases with UBP versus CBP were seen in the sensitivity analysis. These real‐world data showed an association between suboptimal BP control in patients with aTRH and higher incidence of MACE+ and ESRD linked with UBP despite the use of multidrug regimens. Thus, there remains a need for improved aTRH management.

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Citations

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References

Details

Published: Jul 17, 2023
Vol/Issue: 25(8)
Pages: 737-747
License: View

Authors

G

George Bakris

University of Chicago Medicine Chicago Illinois USA

C

Cindy Chen

Janssen Scientific Affairs, LLC Titusville New Jersey USA

A

Alicia K. Campbell

Janssen Scientific Affairs, LLC Titusville New Jersey USA

V

Veronica Ashton

Janssen Scientific Affairs, LLC Titusville New Jersey USA

L

Lloyd Haskell

Janssen Research & Development, LLC Raritan New Jersey USA

M

Mukul Singhal

Janssen Scientific Affairs, LLC Titusville New Jersey USA

Cite This Article

George Bakris, Cindy Chen, Alicia K. Campbell, et al. (2023). Association of uncontrolled blood pressure in apparent treatment‐resistant hypertension with increased risk of major adverse cardiovascular events plus. The Journal of Clinical Hypertension, 25(8), 737-747. https://doi.org/10.1111/jch.14701

Association of uncontrolled blood pressure in apparent treatment‐resistant hypertension with increased risk of major adverse cardiovascular events plus

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