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Prognostic impact of home blood pressures for adverse cardiovascular outcomes and mortality in patients with resistant hypertension: A prospective cohort study

Hypertension Sep 30, 2021

Cardoso CRL, Salles GF, et al. - Among patients suffering from resistant hypertension, adverse cardiovascular outcomes and mortality were predicted by higher/uncontrolled home blood pressure (HBP) levels. In such patient population, improved risk discrimination was provided by higher/uncontrolled HBP levels.

  • A total of 333 patients with resistant hypertension were included.

  • Patients had 24-hour ambulatory and HBP monitoring done at baseline and were followed up for a median of 5.6 years.

  • Significantly higher risks of all adverse outcomes were observed in relation to continuous HBP parameters, with hazard ratios varying from 1.7 to 2.1, post-adjustments for office and ambulatory blood pressures (BPs).

  • Uncontrolled HBP, in dichotomical analyses, was related to significantly higher risks of all outcomes, except for the evening HBP.

  • The highest risks were observed in relation to morning HBP.

  • Improved risk discrimination equivalent to that obtained from ambulatory BPs was provided by HBP parameters, except for all-cause and cardiovascular mortalities, in which ambulatory BPs afforded greater improvements vs HBPs.

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