Prevalence of Apparent treatment resistant hypertension and associated factors among hypertensive patients attending cardiology & nephrology follow up St. Paul Hospital Millennium Medical Collage

Abstract

Abstract Background: Globally, around 10% of patients & 14.7% of patients with hypertension have true resistant hypertension and apparent treatment resistant hypertension (aTRH) respectively. Older age, black race, obesity, diabetes & CKD are common risk factors associated with RH. Objective: The aim of this study was to measure the prevalence of apparent treatment resistant hypertension and assess socio demographic, lifestyle & medical related factors associated with apparent treatment resistant hypertension in hypertensive patients on follow up at cardiology & nephrology clinic of SPHMMC. Methods: A cross sectional analytical study was conducted in cardiology & nephrology clinic of SPHMMC. Using systematic random sampling, 427 patients were selected and included in the study. The study was conducted from February 2023 - February 2024. Data was collected both from face-to-face interview & from medical records using data collection checklist which contains parameters on sociodemographic, lifestyle & medical related questions. Data analysis was conducted using SPSS version 27.0. Both bivariable & multivariable logistic regression models were carried out. p-value of < 0.05 in the multivariable logistic regression analysis was considered as statistically significant. Result: A total of 427 adult hypertensive patients were enrolled in the study and more than half 227 (53.2%) were females. The average age of the patients was 54.2 ± 14.1 years & average duration of hypertension was 7.2 ± 7.8 years. Around 35% of the patients had family history of hypertension & 381 (93.8%) of patients had associated comorbidity. Out of the total patients enrolled, 249 (58.3%) had uncontrolled BP. 19 (4.4 %) of the enrolled hypertensive patients were found to have apparent treatment resistant hypertension & 2 (0.4%) had pseudo resistant hypertension due to adherence issues. Furthermore, patients that had CKD as a comorbidity (AOR 3.017; p < 0.05) were significantly associated with aTRH. Conclusion: Apparent treatment resistant hypertension was found in 4.4% of hypertensive patients. Hypertensive patients with CKD were significantly associated with aTRH. Keywords: Apparent treatment resistant hypertension, Resistant hypertension