Mortality Risk Associated With Resistant Hypertension Among Women: Analysis from Three Prospective Cohorts Encompassing the Spectrum of Women's Heart Disease.
Mortality Risk Associated With Resistant Hypertension Among Women: Analysis from Three Prospective Cohorts Encompassing the Spectrum of Women's Heart Disease.
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与女性难治性高血压相关的死亡风险：对涵盖女性心脏病谱系的三个前瞻性队列进行分析。
DOI：
10.1089/jwh.2015.5609
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Cooper-DeHoff,RhondaM
中科院分区：
文献类型：
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作者：
Smith,StevenM;Huo,Tianyao;Gong,Yan;Handberg,Eileen;Gulati,Martha;Merz,CNoelBairey;Pepine,CarlJ;Cooper-DeHoff,RhondaM
背景：女性发生顽固性高血压（RH）的风险高于男性，但女性RH相关结局的数据很少。我们的目的是确定与表观RH（aRH）相关的所有原因的死亡风险，在所有潜在的冠状动脉疾病的女性中。（WTH;基线时无冠状动脉疾病的女性），女性缺血综合征评估（基线时有缺血体征/症状的女性）和国际维拉帕米-群多普利研究（投资;基线时有冠状动脉疾病和高血压的女性），共计15，108名无高血压、非RH的成年女性（≤2种药物治疗时血压[BP] ≥140/90 mmHg或1-3种药物治疗时BP <140/90 mmHg）或基线aRH（≥3种药物治疗时BP ≥140/90 mmHg或≥4种药物治疗时任何人）。结果：aRH的患病率从0.4%（WTH）到10.6%（INVEST）不等。与没有aRH的女性相比，aRH的女性年龄更大，更经常是黑人，更容易肥胖或糖尿病。合并所有队列，aRH女性的全因死亡风险高于非RH女性（校正HR 1.40; 95% CI 1.27-1.55）和无高血压的女性（校正HR 2.34; 95% CI 1.76-3.11），中位随访时间为14.3年。女性aRH的患病率根据潜在的冠心病而变化，aRH与大量的，早期的，并持续增加全因死亡的风险。需要对RH的早期识别和预防策略进行额外的研究，特别是在黑人和老年妇女以及已知心血管危险因素的妇女中。
Background:Women are at greater risk of developing resistant hypertension (RH) than men, yet scarce data exist on RH-associated outcomes in women. We aimed to determine all-cause mortality risk associated with apparent RH (aRH) among women across the spectrum of underlying coronary disease.Materials and Methods:We analyzed data from St. James Women Take Heart (WTH; women without coronary disease at baseline), Women's Ischemia Syndrome Evaluation (women with signs/symptoms of ischemia at baseline), and the INternational VErapamil-Trandolapril STudy (INVEST; women with coronary artery disease and hypertension at baseline), totaling 15,108 adult women with no hypertension, non-RH (blood pressure [BP] ≥140/90 mmHg on ≤2 drugs or BP <140/90 mmHg on 1–3 drugs), or aRH (BP ≥140/90 mmHg on ≥3 drugs or anyone on ≥4 drugs) at baseline. The primary outcome was all-cause mortality.Results:Prevalence of aRH ranged from 0.4% (WTH) to 10.6% (INVEST). Women with aRH, compared to those without, were older, more often black, and more likely to be obese or diabetic. Pooling all cohorts, risk for all-cause death was greater in women with aRH than in women with non-RH (adjusted HR 1.40; 95% CI 1.27–1.55) and women without hypertension (adjusted HR 2.34; 95% CI 1.76–3.11) over a median follow-up of 14.3 years.Conclusions:aRH prevalence in women varies according to underlying coronary disease, and aRH is associated with a substantial, early, and sustained increased risk of all-cause death. Additional research into early recognition and prevention strategies for RH are needed, especially in black and older women, and those with known cardiovascular risk factors.