Stroke Is Associated with Refractory Hypertension among Resistant and Refractory Patients in a Cross-Sectional Study

Abstract

Hypertension is an important risk factor for adverse cardiovascular events, including stroke. Achieving blood pressure (BP) control, therefore, is an essential step to reduce the impact the condition has on patients' health. However, it is estimated that only 10% of patients with hypertension reach their BP goal. Resistant hypertension (RH) is a phenotype of hypertension characterized by high risk and difficulty in achieving BP goal. 1 It is defined as uncontrolled BP despite the use of 3 or more antihypertensive drugs in adequate doses, including a diuretic, a calcium channel blocker, and a reninangiotensin system blocker, or controlled BP with the use of 4 or more medications. 2,3 This classification allows the identification of patients who share clinical and epidemiological characteristics and who can benefit from specific strategies. 4,5 It is estimated that 11.7% to 13.7% of all patients with hypertension have RH. [6][7][8] Refractory hypertension (RfH) is a severe subtype of RH and is defined as uncontrolled BP despite the use of 5 or more antihypertensive drugs, including spironolactone and a thiazide-like diuretic. 2,3 The prevalence of RfH