| Objective:To analyze and compare the clinical characteristics of inpatients with resistant hypertension and non-resistant hypertension,the choice of antihypertensive drugs,and explore the related factors of resistant hypertension,the relationship with complications and the effect of drug selection on reducing blood pressure.Methods:2896 inpatients with hypertension from 2012 to 2016 were enrolled in this study.According to the diagnostic criteria of resistant hypertension,the patients were divided into resistant hypertension group(RH group,n=834)and non-resistant hypertension group(NRH group,n=2062).The differences in general data,course of hypertension,blood biochemical indicators,drug use and complications between the two groups were analyzed and compared.The influencing factors were included in multiple logistic regression,and the related factors of resistant hypertension were analyzed.Result:1.In this study,834 patients with resistant hypertension accounted for 28.8% of the analyzed population.2.A comparative analysis of population characteristics between RH group and NRH group:The proportion of males(59.4% vs.53.3%),Systolic blood pressure(SBP)(157.8±26.0 vs.138.9±32.5 mmHg),Diastolic blood pressure(DBP)(90.0±17.9 vs.82.3±14.7mmHg),BMI(25.5±13.7vs.24.4±4.9),Smoking rate(22.4% vs.17.5%),Hospital days(HOD)(10.7 ± 6.9 vs.8.8 ± 5.4 days),History of hypertension(9.2 ± 9.7vs.6.8 ± 8.1 years),Serum creatinine(Scr)(104.7 ±116.4vs.77.0 ± 68.1 mmol/L),Fasting blood glucose(5.6 ± 2.3vs.5.3 ± 2.1 mmol/L),Homocysteine(Hcy)(14.2 ± 10.1vs.13.1 ± 10.0 mmol/L),Plamsa renin activity(2.5 ± 3.9vs.2.0 ± 3.4 ng / ml / h),Stroke(23.4% vs.15.8%),Atrial fibrillation(5.3% vs.3.3%),Diabetes mellitus(22.7% vs.17.9%),and Chronic kidney disease(16.0%vs.8.6%)were statistically significant(P < 0.05).3.Compared with the three drug combinations,the proportion of A+B+D,A+C+D,B+C+D combinations in RH group was significantly higher than that in NRH group.A+B+C combinations only existed in NRH group.A+C+D was the most frequently used drug combination in both groups.The blood pressure in the RH group with spironolactone was significantly lower than that in the non-spironolactone group(P < 0.01).4.Whether RH was a binary variable as a dependent variable,univariate regression analysis showed that RH was associated with old age,male,overweight/ obesity,systolic blood pressure,diastolic blood pressure,stroke,atrial fibrillation,diabetes mellitus and chronic kidney disease.Stepwise logistic regression was performed with age,male,overweight/obesity,blood pressure(systolic and diastolic blood pressure),stroke,atrial fibrillation,diabetes and chronic kidney disease as independent variables.The results showed that RH was associated with old age(OR 1.39;95% CI 1.10-1.75,P=0.005),male(OR 1.26;95% CI 1.02-1.55,P=0.031),overweight/obesity(OR 1.34;95% CI 1.08-1.65,P=0.007),blood pressure closure.Compression(OR 1.03;95% CI 1.02-1.03,P < 0.001),atrial fibrillation(OR 1.81;95% CI 1.11-2.96,P = 0.018),diabetes mellitus(OR 1.35;95% CI 1.05-1.73,P = 0.021)and chronic kidney disease(OR 1.60;95% CI 1.17-2.17,P = 0.003)were independently correlated.Conclusion:The proportion of male patients,history of hypertension and hospital days in RH group were significantly higher than those in NRH group,and more combined with other diseases such as atrial fibrillation,diabetes and chronic kidney disease.Furthermore,it was found that elderly men,overweight/obesity and high baseline systolic blood pressure were susceptible to resistant hypertension.And spironolactone plays an important role in lowering blood pressure in patients with resisitant hypertension. |
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