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The Burden of Resistant Hypertension Across the World

  • Resistant Hypertension (L Drager, Section Editor)
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Abstract

Purpose of Review

Resistant hypertension (R-HTN) is related to worse cardiovascular, renal outcomes, and death compared to non R-HTN. We aimed to review the burden of R-HTN across the world, focusing on its prevalence, associated factors and outcomes, and the impact of treatment.

Recent Findings

R-HTN prevalence among hypertensive individuals varies around 10–20%, depending on the population and definition applied. R-HTN consistently relates to older age, chronic kidney disease, obesity, and obstructive sleep apnea – which are increasing in prevalence with global population aging. As such, R-HTN prevalence is also expected to rise. Infrequent use of ambulatory blood pressure monitoring to identify at higher risk individuals and poor adherence to treatment are still barriers in the approach of R-HTN.

Summary

Available evidence suggests that 10–20% of patients with hypertension have R-HTN. However, the prevalence of true R-HTN using contemporaneous standardized definitions is still unknown. Novel strategies to address clinicians, patients and health system barriers to treatment inertia and adherence are fundamental to reduce the burden of R-HTN.

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Funding

Dr Ribeiro is supported in part by CNPq (310679/2016–8 and 465518/2014–1) and by FAPEMIG (PPM-00428–17 and RED-00081–16. Dr Nascimento is partially financed by CNPq (Bolsa de produtividade em pesquisa, 312382/2019–7), by the Edwards Lifesciences Foundation (Improving the Prevention and Detection of Heart Valve Disease Across the Lifespan, 2021), and by FAPEMIG (grant APQ-000627–20).

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  1. Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, 30130-100, Belo Horizonte, MG, Brazil

    Luisa Campos Caldeira Brant, Fabio Morato de Castilho, Antonio Luiz Pinho Ribeiro & Bruno Ramos Nascimento

  2. Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 110, Santa Efigênia, 30130-100, Belo Horizonte, MG, Brazil

    Luiz Guilherme Passaglia, Marcelo Martins Pinto-Filho, Fabio Morato de Castilho & Bruno Ramos Nascimento

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  1. Luisa Campos Caldeira Brant
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Correspondence to Luisa Campos Caldeira Brant or Bruno Ramos Nascimento.

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Luisa C C Brant, Luiz G. Passaglia, Marcelo M Pinto-Filho, Fabio M de Castilho, Antonio L P Ribeiro, and Bruno R Nascimento declare that they have no conflict of interest.

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Brant, L.C.C., Passaglia, L.G., Pinto-Filho, M.M. et al. The Burden of Resistant Hypertension Across the World. Curr Hypertens Rep 24, 55–66 (2022). https://doi.org/10.1007/s11906-022-01173-w

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