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ABSTRACTObjectiveResistant hypertension (RHT) is a more risky HT phenotype in terms of mortality and morbidity. It is more common in people living with diabetes. Studies have shown that visceral adipose index (VAI), a new obesity parameter, is associated with HT and diabetes mellitus (DM). The association of VIA with RHT has not been previously evaluated. The aim of this study is to analyze the relationship between VAI and RHT in people living with diabetes.MethodsWe have conducted a single-center, retrospective study in patients with HT and DM (n = 557). Patients were divided into RHT (n = 274) and non-RHT (n = 283) groups. Patients using 3 or more antihypertensive drugs, one of which was a diuretic drug, were defined as RHT. VAIs of the patients were calculated according to gender.ResultsVAI was significantly higher in the RHT group compared to the non-RHT group (4.59 ± 2.77 vs. 3.73 ± 2.31, p < 0.001). Multivariate regression analysis revealed that coronary artery disease (OR 2.099 (1.327–3.318), p = 0.002), waist circumference (OR 1.043 (1.026–1.061), p < 0.001) and VAI (OR 1.216 (1.062–1.339), p = 0.005) were independent risk factors for the development of RHT in people living with diabetes. In addition, smoking, high triglyceride levels, and low high-density lipoprotein levels were among the predictive factors for RHT in people living with diabetes.ConclusionIn our study, we have determined that increased VAI is an independent risk factor for RHT in people living with diabetes. VAI may have better ability to predict RHT than many other parameters.