Abstract：
BACKGROUND:Visceral obesity increases the risk of arterial hypertension (78% of cases of hypertension in men and 65% of cases in women). The aim of the study is to assess the role of visceral obesity in causing resistant hypertension (RH). METHODS:The survey was performed on 5065 hypertensive patients with visceral obesity. BP control was analyzed on the basis of office and home BP measurements. Patients reporting non-compliance were excluded from the study. RESULTS:The percentage of RH after excluding undertreated patients (receiving less than 3 drugs or on at least 3-drug regimen without diuretic and without reaching target BP goal) was 13.9%. RH was more frequent only in obese with BMI ≥ 35 and <40 kg/m(2) (16.2%) and in morbidly obese individuals (26.5%). Patients with BMI ≥ 35 and <40 kg/m(2) and with morbid obesity were receiving three-drug therapy more frequently than patients with visceral obesity and BMI<30 kg/m(2). A multiple regression analysis revealed that obesity was associated with RH independent from longer than 5-year period of antihypertensive therapy, diabetes, smoking cigarettes, cardiovascular disease and heart failure. The analysis of home BP measurement revealed that in 11.1% of patients RH was in fact "white coat" hypertension. CONCLUSIONS:Undertreatment, underuse of diuretics in multidrug regimens, and the "white-coat" effect are the most common reasons for over-diagnosing resistant hypertension in patients with visceral obesity. Obesity is an independent risk factor for the occurrence of RH.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
Holecki M,Duława J,Chudek Jdoi
10.1016/j.ejim.2012.04.012subject
Has Abstractpub_date
2012-10-01 00:00:00pages
643-8issue
7eissn
0953-6205issn
1879-0828pii
S0953-6205(12)00119-7journal_volume
23pub_type
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