The incidence of cardiovascular and cerebrovascular complications in patients with uncontrolled hypertension

Abstract

Aim. To assess the incidence of cardiovascular and cerebrovascular events in patients with controlled and uncontrolled hypertension, controlled resistant and uncontrolled resistant hypertension, refractory hypertension, and probably resistant and probably refractory hypertension.
 Materials and methods. A telephone call was made to 256 patients with hypertension included in the database to assess the incidence of cardiovascular and cerebrovascular diseases. All responding patients were divided into 7 groups according to the classification of hypertension based on the achievement/non-achievement of target blood pressure values and the number of drugs taken (controlled and uncontrolled hypertension, controlled resistant and uncontrolled resistant hypertension, refractory hypertension, and probably resistant and probably refractory hypertension). The target blood pressure was considered to be less than 140/90 mm Hg. Patients not adhering to medication were not included in the analysis.
 Results. The group of controlled hypertension included 146 (57%) patients out of 256, controlled resistant hypertension 36 (14%) patients, uncontrolled hypertension 6 (2.3%) patients, resistant uncontrolled hypertension 22 (8.6%) patients, refractory hypertension 31 (12.1%) patients. The group of probably resistant hypertension 6 (2.3%) patients, probably refractory hypertension 9 (3.5%) patients. Of the 28 events that occurred, 6 were attributed to coronary artery disease (including 3 acute myocardial infarction and 2 coronary artery stenting), 3 strokes, 6 episodes of transient ischemic attack and 10 new cases of atrial fibrillation, and 2 patients had sudden cardiac death. Significantly more often, patients with refractory hypertension developed any event compared with patients with controlled (38.7% versus 3.4%; p=0.005) and resistant hypertension (38.7% versus 13.6%; p=0.04). Also, patients from the group of probably refractory hypertension were more likely to develop events than patients with controlled hypertension (33.3% versus 3.4%; p=0.045). Patients with probably refractory hypertension significantly more often had a stroke than patients with controlled hypertension (22.2% versus 0%; p0.05), and patients with refractory hypertension significantly more often had a transient ischemic attack compared with patients from the group of controlled hypertension (12.9% versus 0.7%; p=0.03).
 Conclusion. Patients with refractory and probably refractory hypertension are significantly more likely to develop cardiovascular and cerebrovascular complications than patients with controlled hypertension.

Treatment of Hypertension by Using Natural Herbs and their Mechanism of Action

“…Hypertension is a major risk factor for causing coronary-artery abnormalities, Hypertrophy of the left ventricular, diastolic dysfunction and systolic dysfunction. It is regarded as a heart disease with hypertension that potentially causes heart failure (Denisova et al, 2022). Microcirculation is affected by hypertension, while accelerates atherosclerosis in large vessels (epicedial) are also affected by hypertension.…”

Beta-adrenergic reactivity of erythrocyte membranes in various phenotypes of uncontrolled hypertension

“…Рефрактерная АГ (рфАГ) определяется как артериальное давление (АД), которое не контролируется, несмотря на прием ≥5 антигипертензивных препаратов различных классов, включая тиазидный диуретик длительного действия и антагонист минералокортикоидных рецепторов в максимальных или максимально переносимых дозах. Этот фенотип отличается от неконтролируемой резистентной АГ (РАГ), определяемой при отсутствии целевого уровня АД, несмотря на прием от 3 до 4 препаратов в максималь-ных или максимально переносимых дозах [2], более высоким риском сердечно-сосудистых осложнений [3,4]. При этом предполагается, что в основе рфАГ лежит симпатическая гиперактивация, тогда как для неконтролируемой РАГ в большей степени характерен объем-зависимый механизм повышения АД [5].…”

Association of Uncontrolled Hypertension or Diabetes Mellitus With Major Adverse Cardiovascular Events and Mortality in South Korea: Population-Based Cohort Study

“…Furthermore, individuals with undiagnosed DM have poor long-term glycemic control and can die within a short time after the onset of complication-related symptoms [ 13 ]. The incidence of cardiovascular and cerebrovascular complications was higher in patients with refractory HT on treatment than in those with controlled HT [ 14 ]. The data on recent population-based epidemiological studies conducted in the Asian population are relatively scarce [ 15 ].…”