Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis
Background: Resistant hypertension (RHT) is defined as high blood pressure despite three antihypertensive medications one being a diuretic. RHT is a common clinical problem and as a subgroup has not been studied widely. The present study has investigated patient demographics and if the RHT might be...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-08-01
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| Series: | Clinical and Experimental Hypertension |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10641963.2018.1510945 |
| _version_ | 1797681352737292288 |
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| author | Ebru Ipek Turkoglu Emine Cigdem Kircicegi Cıcekdag |
| author_facet | Ebru Ipek Turkoglu Emine Cigdem Kircicegi Cıcekdag |
| author_sort | Ebru Ipek Turkoglu |
| collection | DOAJ |
| description | Background: Resistant hypertension (RHT) is defined as high blood pressure despite three antihypertensive medications one being a diuretic. RHT is a common clinical problem and as a subgroup has not been studied widely. The present study has investigated patient demographics and if the RHT might be a clinical presentation of heart failure with preserved ejection fraction (HFPEF) in elderly. Method: The outpatient data between January and June 2015 of Izmir Kemalpasa State hospital’s hypertension specialty clinic has been reviewed retrospectively. The patients with pseudo-RHT are excluded. Among 957 patients, 68 patients have been identified as true RHT with a left ventricle ejection fraction ≥50%. HFPEF is defined according to the latest guideline. Instead of a common cut-off level for NT-proBNP, age and gender-related cut-off levels have been used. Results: The mean age was 63.24 ± 12.05 years. Among 68 patients, 49 were female. While only 3 patients in younger group (8.8%) had elevated levels of NT-proBNP, 22 of older RHT patients (64.7%) had high levels. NT-proBNP levels were disproportionally high in elderly (p < 0.001) and high levels in RHT patients were related to a larger left atrial diameter (p < 0.001). Conclusion: The underlying mechanism might be different in RHT according to age. Hypervolemia might be the key factor in older RHT patients but not in younger patients. The current study suggests RHT in elderly can be a clinical presentation of HFPEF, and they should be investigated and treated accordingly. Because of single-center results and limited patients, further studies are needed. |
| first_indexed | 2024-03-11T23:43:38Z |
| format | Article |
| id | doaj.art-1201a77bbf564b828ae16bd6e4f955da |
| institution | Directory Open Access Journal |
| issn | 1064-1963 1525-6006 |
| language | English |
| last_indexed | 2024-03-11T23:43:38Z |
| publishDate | 2019-08-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Clinical and Experimental Hypertension |
| spelling | doaj.art-1201a77bbf564b828ae16bd6e4f955da2023-09-19T15:19:27ZengTaylor & Francis GroupClinical and Experimental Hypertension1064-19631525-60062019-08-0141650551010.1080/10641963.2018.15109451510945Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysisEbru Ipek Turkoglu0Emine Cigdem Kircicegi Cıcekdag1Department of Cardiology, Izmir Kemalpasa State Hospital, Izmir, TurkeyDepartment of Cardiology, Izmir Kemalpasa State Hospital, Izmir, TurkeyBackground: Resistant hypertension (RHT) is defined as high blood pressure despite three antihypertensive medications one being a diuretic. RHT is a common clinical problem and as a subgroup has not been studied widely. The present study has investigated patient demographics and if the RHT might be a clinical presentation of heart failure with preserved ejection fraction (HFPEF) in elderly. Method: The outpatient data between January and June 2015 of Izmir Kemalpasa State hospital’s hypertension specialty clinic has been reviewed retrospectively. The patients with pseudo-RHT are excluded. Among 957 patients, 68 patients have been identified as true RHT with a left ventricle ejection fraction ≥50%. HFPEF is defined according to the latest guideline. Instead of a common cut-off level for NT-proBNP, age and gender-related cut-off levels have been used. Results: The mean age was 63.24 ± 12.05 years. Among 68 patients, 49 were female. While only 3 patients in younger group (8.8%) had elevated levels of NT-proBNP, 22 of older RHT patients (64.7%) had high levels. NT-proBNP levels were disproportionally high in elderly (p < 0.001) and high levels in RHT patients were related to a larger left atrial diameter (p < 0.001). Conclusion: The underlying mechanism might be different in RHT according to age. Hypervolemia might be the key factor in older RHT patients but not in younger patients. The current study suggests RHT in elderly can be a clinical presentation of HFPEF, and they should be investigated and treated accordingly. Because of single-center results and limited patients, further studies are needed.http://dx.doi.org/10.1080/10641963.2018.1510945resistant hypertensionelderlyhfpefnt-probnpleft atrial diameter |
| spellingShingle | Ebru Ipek Turkoglu Emine Cigdem Kircicegi Cıcekdag Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis Clinical and Experimental Hypertension resistant hypertension elderly hfpef nt-probnp left atrial diameter |
| title | Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis |
| title_full | Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis |
| title_fullStr | Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis |
| title_full_unstemmed | Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis |
| title_short | Resistant hypertension in elderly: a clinical manifestation of heart failure with preserved ejection fraction? retrospective single-center analysis |
| title_sort | resistant hypertension in elderly a clinical manifestation of heart failure with preserved ejection fraction retrospective single center analysis |
| topic | resistant hypertension elderly hfpef nt-probnp left atrial diameter |
| url | http://dx.doi.org/10.1080/10641963.2018.1510945 |
| work_keys_str_mv | AT ebruipekturkoglu resistanthypertensioninelderlyaclinicalmanifestationofheartfailurewithpreservedejectionfractionretrospectivesinglecenteranalysis AT eminecigdemkircicegicıcekdag resistanthypertensioninelderlyaclinicalmanifestationofheartfailurewithpreservedejectionfractionretrospectivesinglecenteranalysis |