Resistant Hypertension in Chronic Kidney Disease

RH Definitions

: (1) Office BP

≥
140/90 mmHg despite

≥
3 anti-hypertensive medications (2) Office BP

≥
130/80 mmHg despite

≥3 antihypertensive drugs including a

diuretic in full dosages or <130/80 mmHg requiring

≥

4 antihypertensive drugs in full doses (3) Office BP

≥

140/90 mmHg despite

≥

3 antihypertensive drugs including a

diuretic in full dosages or requiring

≥

4 antihypertensive medications regardless of BP

Notes

:^1

. Relative risk reported.

2. CV event was composite outcome of fatal and nonfatal CV events 3. Renal event is composite outcome of all-cause death, dialysis, or

transplantation.

4. CV event is CV mortality

5. Hazard Ratios compare RH in the presence or absence of microalbuminuria. Adjusted Hazard Ratios for eGFR <60 mL/

min/1.73 m

2 with microalbuminuria (§2.90; 95% CI, 1.52–5.52) were greater than for those without microalbuminuria (1.38; 95% CI, 0.73–2.63).

6. CV event was com-

posite of nonfatal MI, CCF, stroke and new-onset CKD by diagnostic coding or MDRD-eGFR <60 mL/min/1.73 m

2 on 2 occasions after follow-up. New-onset CKD was

the predominant CV event.

8. Unadjusted renal outcomes of new-onset CKD were 14.5% for RH versus 10.4% for non-RH.

8. CV event was composite of fatal and non-

fatal CV events

10

. Renal event was composite of death due to renal disease or requiring dialysis or renal transplantation

10

. CV event was composite of nonfatal myocar

dial infarction or death due to coronary heart disease.

11

. Renal event was requiring dialysis or renal transplantation

12

. Renal event defined as 50% decrease in eGFR,

dialysis, or renal transplantation

13

. CV event was by incident diagnostic coding for coronary events comprising myocardial infarction, angina, percutaneous coronary

intervention, or coronary bypass grafting

14

. Renal event was rapid CKD progression as defined by MDRD-eGFR decline >5 mL/min/year with separate Hazard Ratios

reported for RH versus non-RH that was controlled 2.78 (1.33–5.81) or uncontrolled 2.91(1.49–5.70)Abbreviations

: ABPM

ambulatory blood pressure monitoring,

CKD

chronic kidney disease,

eGFR

estimated glomerular filtration rate in mL/min/1.73 m

2 ,

HR

hazard ratio,

NR

not reported,

RCT

randomized controlled trial,

RH

resistant hypertension

aAge and eGFR are ±SD or (25th–75th centile)bSerum creatinine in mg/dlcSerum creatinine in

μmol/l