Apparent Treatment-Resistant Hypertension and Cardiovascular Risk in Hemodialysis Patients

Ten-Year Outcomes of the Q-Cohort Study

Shigeru Tanaka, Toshiharu Ninomiya, Hiroto Hiyamuta, Masatomo Taniguchi, Masanori Tokumoto, Kosuke Masutani, Hiroaki Ooboshi, Toshiaki Nakano, Kazuhiko Tsuruya, Takanari Kitazono

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Abstract

There has been limited data discussing the relationship between apparent treatment-resistant hypertension (ATRH) and cardiovascular disease risk in patients receiving maintenance hemodialysis. We analyzed data for 2999 hypertensive patients on maintenance hemodialysis. ATRH was defined as uncontrolled blood pressure despite the use of three or more classes of antihypertensive medications, or four or more classes of antihypertensive medications regardless of blood pressure level. We examined the relationships between ATRH and cardiovascular events using a Cox proportional hazards model. The proportion of participants with ATRH was 18.0% (539/2999). During follow-up (median: 106.6 months, interquartile range: 51.3–121.8 months), 931 patients experienced cardiovascular events including coronary heart disease (n = 424), hemorrhagic stroke (n = 158), ischemic stroke (n = 344), and peripheral arterial disease (n = 242). Compared with the non-ATRH group, the ATRH group showed a significant increased risk of developing cardiovascular disease (hazard ratio [HR]: 1.27; 95% confidence interval [CI]: 1.08–1.49), coronary heart disease (HR: 1.28; 95% CI: 1.01–1.62), ischemic stroke (HR: 1.31; 95% CI: 1.01–1.69), and peripheral arterial disease (HR: 1.42; 95% CI: 1.06–1.91) even after adjusting for potential confounders. This study demonstrated that ATRH was significantly associated with increased cardiovascular risk in hemodialysis patients.

Original languageEnglish
Article number1043
JournalScientific reports
Volume9
Issue number1
DOIs
Publication statusPublished - Dec 1 2019

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Renal Dialysis
Cohort Studies
Hypertension
Confidence Intervals
Peripheral Arterial Disease
Stroke
Antihypertensive Agents
Therapeutics
Coronary Disease
Cardiovascular Diseases
Maintenance
Blood Pressure
Proportional Hazards Models

All Science Journal Classification (ASJC) codes

  • General

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Apparent Treatment-Resistant Hypertension and Cardiovascular Risk in Hemodialysis Patients : Ten-Year Outcomes of the Q-Cohort Study. / Tanaka, Shigeru; Ninomiya, Toshiharu; Hiyamuta, Hiroto; Taniguchi, Masatomo; Tokumoto, Masanori; Masutani, Kosuke; Ooboshi, Hiroaki; Nakano, Toshiaki; Tsuruya, Kazuhiko; Kitazono, Takanari.

In: Scientific reports, Vol. 9, No. 1, 1043, 01.12.2019.

Research output: Contribution to journalArticle

Tanaka, Shigeru ; Ninomiya, Toshiharu ; Hiyamuta, Hiroto ; Taniguchi, Masatomo ; Tokumoto, Masanori ; Masutani, Kosuke ; Ooboshi, Hiroaki ; Nakano, Toshiaki ; Tsuruya, Kazuhiko ; Kitazono, Takanari. / Apparent Treatment-Resistant Hypertension and Cardiovascular Risk in Hemodialysis Patients : Ten-Year Outcomes of the Q-Cohort Study. In: Scientific reports. 2019 ; Vol. 9, No. 1.
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