[Association between refractory hypertension and cardiometabolic risk. The HIPERFRE study].

Background And Aim: Resistant hypertension (R-HT) is defined by the presence of uncontrolled blood pressure in patients treated with three or more drugs, being one of them diuretic. We sough to evaluate the prevalence and features of patients with R-HT attended at Primary Care of our environment.

Method: 1724 hypertensive patients attended by 35 physicians at 14 Primary Care Units were analyzed in this descriptive, transversal, multicentral study.

Results: Patients (41.5% males) with a mean age of 67+/-11 years, being half of them obese. Blood pressure is controlled in 41.6% and the prevalence of R-HT is of 13.2%. This later group of patients is characterized by an older age (69 vs 67 years, p<0.01) and more frequent obesity (62% vs 43%, p<0.001), diabetes (55% vs 11%, p<0.001), hyperlipidemia (68% vs 59%, p<0.05), and metabolic syndrome (68% vs 22%, p<0.001). At least half of them present some kind of end-organ damage. No pharmacologycal treatment is prescribed to 3% of these patients and 37% of them are on monotherapy. There is a higher prescription of angiotensin receptor, calcium channel, beta and alfa-blockers in the group of patients with R-HT. There is an independent and direct relationship between R-HT and age, male gender, diabetes, obesity, metabolic syndrome, and an inverse relationship with ischemic cardiopathy.

Conclusions: The prevalence of R-HT at Primary Care Units is of 13% and is related with age, male gender and metabolic risk factors.