1. High Prevalence of Secondary Hypertension and Insulin Resistance in Patients with Refractory Hypertension.
- Author
-
MARTELL, NIEVES, RODRIGUEZ-CERRILLO, MATILDE, E., GROBBEE D., M., DOLORES LÓPEZ-EADY, FERNÁNDEZ-PINILLA, CARMEN, AVILA, MARIO, FERNANDEZ-CRUZ, ARTURO, and LUQUE, MANUEL
- Subjects
HYPERTENSION ,INSULIN resistance ,PATIENTS ,DISEASES - Abstract
Objective: To determine causes of treatment resistance in patients with refractory hypertension, and to estimate the prevalence of true resistant hypertension. Methods: We studied 50 consecutive patients referred with refractory hypertension after exclusion of hypokalemia and stenosis of the renal artery. Ambulatory blood pressure monitoring was performed in all patients to detect white-coat effect. The patients were hospitalized, antihypertensive drugs were withdrawn and a screening for secondary hypertension was performed. In addition, these patients, and a control group of essential hypertensives controlled with three antihypertensive drugs, underwent a OGTT with 75 g of glucose. Results: Primary normokaliemic hyperaldosteronism was diagnosed in seven patients. Two patients had a pheochromocytoma and six had white-coat effect. The 35 remaining patients with true resistant hypertension shown significant differences in serum insulin and HOMA IR when compared with the control group. Conclusions: These findings show that among normokaliemic treatment-resistant hypertension, the presence of hyperaldosteronism and pheochromocitoma is quite high. Moreover, treatment resistance in hypertensive patients appears to be associated with insulin resistance. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF