Prevalence and Characteristics of Treatment-Resistant Hypertension among Hypertensive Japanese Outpatients

Okamura, Keisuke; Urata, Hidenori

doi:10.4236/ijcm.2015.69083

Cited by 1 publication

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of RHT-G in the present study (6.5%) was slightly lower than that reported in studies from the U.S. Since it the salt intake is reported to be higher in Japan ( 29 ), the effect of diuretics may be stronger in Japanese HT patients; this may be responsible for the lower prevalence of RHT ( 14 ).…”

Section: Discussioncontrasting

confidence: 76%

“…The highly limited indication for RDN treatment is one reason for the extremely small number of eligible patients ( 4 , 32 ). We previously reported that the patients in whom RDN was indicated often had chronic kidney disease, cardiomegaly and arteriosclerosis ( 14 ). Generally, patients requiring 3 types of antihypertensive drugs have advanced nephrosclerosis and are frequently complicated with renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Only 41 patients were enrolled in the SH-J trial, which shows the difficulties associated with recruiting patients. We previously reported that there were very few patients with RHT whose SBP was ≥160 mmHg despite treatment with 3 or more oral antihypertensive drugs (including 1 diuretic) among consecutive outpatients with HT ( 14 ). Moreover, due to the inclusion of the sham catheter group and the fact that a number of treatment resistant patients have already been enrolled in SH-J, it is expected that patient enrollment will be difficult.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Prevalence of Japanese Outpatients with Hypertension Who Meet the Definition of Treatment Resistant Hypertension and Are Eligible for Enrolment in Clinical Trials of Endovascular Ultrasound Renal Denervation

et al. 2018

Self Cite

View full text Add to dashboard Cite

Objective A clinical trial (REQUIRE) was started to investigate the use of an ultrasound renal denervation system in the treatment of resistant hypertension (RHT). We analyzed the prevalence of patients who were eligible for inclusion in this cross-sectional study at the time of screening. Methods Nine-hundred ninety-nine consecutive hypertension (HT) patients who were treated in our hospital as outpatients were classified into the following categories: patients treated with at least 3 types of antihypertensive drugs including diuretic agents who were eligible for enrolment in SYMPLICITY HTN-Japan (SH-J) with an office systolic blood pressure (SBP) of ≥160 mmHg, who were ≤80 years of age, and an estimated glomerular filtration rate (eGFR) of ≥45 mL/min/1.73 m2 (RHT-S); and patients who were treated similar medications and who were eligible for enrolment in REQUIRE, with an SBP of ≥150 mmHg, ≤75 years of age, and an eGFR of ≥40 mL/min/1.73 m2 (RHT-R). We investigated the proportion of patients in each category. We also investigated HT patients (1,423 cases) who were enrolled in the Chikushi Anti-Hypertension Trial (CHAT), a research network that includes general practitioners. Results Eleven patients (1.1%) with RHT-S and 18 patients (1.8%) with RHT-R were identified. After the exclusion of patients with secondary HT and a diastolic blood pressure (DBP) of <90 mmHg (applied in REQUIRE), 5 patients (0.5%) with RHT-S and 4 patients (0.4%) with RHT-R remained. In the analysis of the CHAT study, only 2 (0.1%) patients with RHT-R remained. Conclusion The number of eligible patients in the REQUIRE trial was decreased, largely due to the strict age restriction and the new DBP limitation. The prevalence of eligible patients in REQUIRE was estimated to be approximately 0.5 to 0.8 times that in SH-J. Since patient enrollment will be difficult, drastic measures may be required to recruit eligible patients.

show abstract

Section: Discussioncontrasting

confidence: 76%