Table 1
Basal characteristics, risk factors and socioeconomic factors of all patients in both groups.
| GROUP I (N = 842) (CONTROLLED HTN) | GROUP II (N = 148)(RESISTANT HTN) | P. VALUE | |
|---|---|---|---|
| Age, years | 61.01 ± 11.02 | 62.94 ± 10.89 | 0.049* |
| Male gender, n (%) | 437 (51.9%) | 80 (54.1%) | 0.629 |
| Smoking, n (%) | 299 (35.5%) | 49 (33.1%) | 0.572 |
| Diabetes, n (%) | 261 (31.0%) | 51 (34.5%) | 0.403 |
| Dyslipidemia, n (%) | 307 (36.5%) | 52 (35.1%) | 0.757 |
| Cardiovascular diseases, n (%) | 159 (18.9%) | 30 (20.3%) | 0.692 |
| Chronic Kidney diseases, n (%) | 168 (20.0%) | 41 (27.7%) | 0.033* |
| Cerebrovascular diseases, n (%) | 80 (9.5%) | 19 (12.8%) | 0.212 |
| Peripheral vascular diseases, n (%) | 102 (12.1%) | 24 (16.2%) | 0.167 |
| Obstructive sleep apnea, n (%) | 44 (5.2%) | 14 (9.5%) | 0.043* |
| Obesity, n (%) | 172 (20.4%) | 42 (28.4%) | 0.030* |
| Family history of high blood pressure, n (%) | 271 (32.2%) | 48 (32.4%) | 0.953 |
| Lack of physical activity, n (%) | 448 (53.2%) | 86 (58.1%) | 0.270 |
| Atrial fibrillation, n (%) | 109 (12.9%) | 25 (16.9%) | 0.196 |
| Non-steroidal anti-inflammatory drugs use, n (%) | 136 (16.2%) | 34 (23.0%) | 0.042* |
| Antidepressant drugs use, n (%) | 50 (5.9%) | 6 (4.1%) | 0.360 |
| Corticosteroid drugs use, n (%) | 52 (6.2%) | 12 (8.1%) | 0.378 |
| Cholesterol lowering medication use, n (%) | 442 (52.5%) | 72 (48.6%) | 0.388 |
| Antiplatelet medication use, n (%) | 377 (44.8%) | 64 (43.2%) | 0.730 |
| Diuretics, n (%) | 601 (71.4%) | 148 (100%) | 0.001* |
| Beta-blocker, n (%) | 535 (63.5%) | 98 (66.2%) | 0.532 |
| ACE inhibitors OR ARB, n (%) | 513 (60.9%) | 133 (89.9%) | 0.001* |
| Calcium channel blocker, n (%) | 495 (58.8%) | 127 (85.8%) | 0.001* |
| Others, n (%) | 245 (29.1%) | 42 (28.4%) | 0.859 |
| History of non-adherence to medication, n (%) | 297 (35.3%) | 65 (43.9%) | 0.044* |
| Marital status, married, n (%) | 495 (58.8%) | 88 (59.5%) | 0.878 |
| Income category, low income, n (%) | 477 (56.7%) | 89 (60.1%) | 0.430 |
| Level of education, lower, n (%) | 369 (43.8%) | 78 (52.7%) | 0.045* |
| Residence, urban, n (%) | 481 (57.1%) | 82 (55.4%) | 0.697 |
| Occupational status, employed, n (%) | 450 (53.4%) | 77 (52.0%) | 0.750 |
| Health insurance, n (%) | 347 (41.2%) | 60 (40.5%) | 0.878 |
| Excessive salty diet, n (%) | 409 (48.6%) | 90 (60.8%) | 0.006* |
[i] *: Significant P value, ACE: angiotensin converting enzyme; ARB, angiotensin receptor blockers.
Table 2
Clinical, laboratory findings and echocardiographic data of all patients in both groups.
| GROUP I (N = 842) (CONTROLLED HTN) | GROUP II (N = 148)(RESISTANT HTN) | P. VALUE | |
|---|---|---|---|
| BMI, (kg/m2) | 26.72 ± 4.45 | 29.18 ± 3.38 | 0.001* |
| Heart rate, (bpm) | 79.74 ± 15.2 | 81.99 ± 18.0 | 0.107 |
| Systolic BP, mmHg | 129.4 ± 11.6 | 159.5 ± 17.3 | 0.001* |
| Diastolic BP, mmHg | 80.59 ± 8.34 | 95.20 ± 8.76 | 0.001* |
| Fasting plasma glucose (mg/dl) | 118.5 ± 17.2 | 117.1 ± 16.6 | 0.362 |
| 2-h post prandial plasma glucose (mg/dl) (mg/dl) (mmol/L) | 167.8 ± 31.1 | 168.6 ± 40.5 | 0.784 |
| HbA1c % | 6.354 ± 1.26 | 6.428 ± 1.28 | 0.513 |
| Hemoglobin, g/dl | 12.05 ± 1.06 | 12.07 ± 1.05 | 0.825 |
| TSH (mlU/L) | 4.31 ± 1.91 | 4.53 ± 2.85 | 0.233 |
| Total cholesterol (mg/dl) | 223.9 ± 38.8 | 224.0 ± 45.1 | 0.982 |
| Triglycerides (mg/dl) | 165.8 ± 32.3 | 163.6 ± 27.6 | 0.428 |
| LDL (mg/dl) | 137.4 ± 27.0 | 141.3 ± 30.1 | 0.111 |
| HDL (mg/dl) | 43.68 ± 7.34 | 44.33 ± 7.93 | 0.324 |
| Serum creatinine (mg/dl) | 1.13 ± 0.50 | 1.25 ± 0.60 | 0.012* |
| e-GFR (mL/min/1.73 m2) | 92.09 ± 17.2 | 89.09 ± 15.0 | 0.047* |
| Albuminuria (mg/g) | 29.01 ± 5.01 | 29.12 ± 4.04 | 0.791 |
| Serum potassium (mmol/L) | 4.49 ± 0.79 | 4.48 ± 0.79 | 0.945 |
| Uric acid (mg/dl) | 5.69 ± 1.07 | 5.58 ± 1.30 | 0.250 |
| Ankle brachial index | 1.04 ± 0.14 | 1.02 ± 0.13 | 0.140 |
| LVEDD (cm) | 5.75 ± 0.51 | 5.71 ± 0.57 | 0.326 |
| LVESD (cm) | 3.85 ± 0.43 | 3.78 ± 0.44 | 0.088 |
| LVEF, (%) | 62.76 ± 3.77 | 62.54 ± 4.48 | 0.524 |
| LVH, n (%) | 395 (46.9%) | 88 (59.5%) | 0.005* |
| E/A | 1.37 ± 0.42 | 1.39 ± 0.42 | 0.631 |
| E/E’ | 11.5 ± 1.36 | 11.8 ± 1.03 | 0.019* |
| LAVI (ml/m2) | 33.6 ± 1.70 | 34.1 ± 3.04 | 0.016* |
| LVMI (gr/m2) | 115.2 ± 27.1 | 122.7 ± 25.3 | 0.002* |
| Carotid IMT (mm) | 0.99 ± 0.11 | 0.98 ± 0.10 | 0.274 |
[i] BMI: body mass index, BP: blood pressure, HbA1c: glycated hemoglobin, TSH: thyroid stimulating hormones, LDL: low density lipoprotein, HDL: high density lipoprotein, e-GFR: estimated glomerular filtration rate, LVEDD: left ventricle end-diastolic dimensions, LVESD: left ventricle end-systolic dimensions LVEF: left ventricle ejection fraction, LVH: left ventricular hypertrophy, E: peak early diastolic velocity, A: peak late diastolic velocity, E’: peak early diastolic myocardial velocity, LAVI: left atrium volume index, LVMI: left ventricular mass index, IMT: intima media thickness, *: Significant P value.
Table 3
Major cardiovascular events of both groups after one year of follow up.
| GROUP I (N = 842) (CONTROLLED HTN) | GROUP II (N = 148)(RESISTANT HTN) | P. VALUE | |
|---|---|---|---|
| Mortality, n (%) | 6 (0.7%) | 2 (1.4%) | 0.423 |
| New onset atrial fibrillation, n (%) | 21 (2.5%) | 10 (6.8%) | 0.006* |
| Transient ischemic attacks, n (%) | 12 (1.4%) | 5 (3.4%) | 0.092 |
| Cerebral stroke, n (%) | 10 (1.2%) | 6 (4.1%) | 0.011* |
| Cerebral hemorrhage, n (%) | 7 (0.8%) | 3 (2.0%) | 0.180 |
| Unstable angina, n (%) | 25 (3.0%) | 9 (6.1%) | 0.055 |
| Myocardial infarction, n (%) | 11 (1.3%) | 7 (4.7%) | 0.004* |
| Acute peripheral vascular ischemia, n (%) | 9 (1.1%) | 4 (2.7%) | 0.107 |
| Acute heart failure, n (%) | 15 (1.8%) | 7 (4.7%) | 0.025* |
[i] *: Significant P value.
Figure 1
Major cardiovascular events of both groups after one year of follow up.
Table 4
Multivariate regression analysis showing the independent predictors affecting cardiovascular outcomes.
| MULTIVARIATE ANALYSIS | P. VALUE | ||
|---|---|---|---|
| OR | (95% CI) | ||
| Age ≥ 65 years | 5.449 | 2.237–13.274 | 0.001* |
| Chronic Kidney diseases | 5.083 | 2.111–12.240 | 0.001* |
| Obstructive sleep apnea | 1.809 | 0.473–6.910 | 0.386 |
| Body mass index ≥ 30 kg/m2 | 3.095 | 1.339–7.153 | 0.008* |
| History of non-adherence to medication | 1.439 | 0.418–4.955 | 0.564 |
| Non-steroidal anti-inflammatory drugs use | 5.681 | 2.585–12.487 | 0.001* |
| Lower level of education | 1.687 | 0.591–4.815 | 0.328 |
| Excessive salty diet | 2.540 | 0.911–7.079 | 0.075 |
[i] *: Significant P value.