LAUSR

Objective: Resistant hypertension is defined as high blood pressure despite treatment with at least 3 different class of antihypertensive drugs at best tolerated doses. One of the antihypertensive drugs has to be diuretic by definition. Resistant hypertension is a common clinical problem, the exact prevalence is not known. Pseudo resistance (poor medical adherence, white coat hypertension) must be excluded. As a subgroup, resistant hypertensive patients have not been studied widely. The present study has investigated if the resistant hypertension in elderly is a clinical presentation of HFpEF. Design and method: The outpatient data of 661 patients < 65 years and 254 patients > 65 years, who applied between 1–30 th of April 2015 to the cardiology clinic of the Kemalpasa state hospital, is reviewed. The patients with pseudo resistant hypertension (i.e. poor adherence to medical therapy, inadequate dosage, white coat hypertension), secondary hypertension (i.e. chronic renal or renovascular disease), heart failure reduced EF are excluded. All the resistant hypertensive patients have had an echocardiogram, renal Doppler exam, NT-proBNP level, routine biochemistry and urine exam. 58 patients are identified as true resistant hypertensive and have had EF>50, no moderate to severe valvular disease, no renal dysfunction. The present study has investigated if the NT-proBNP levels in the resistant hypertension differs with age. Results: The mean age was 63 ± 11 years. 49 of patients were younger and 9 were older than 75 years. The cut-off levels for NT- proBNP were accepted as <300 pg/ml for patients younger than 75 years and <600 pg/ml for patients older than 75 years. The median NT-proBNP level was significantly higher in the older group (p < 0,05) whereas the median NT-proBNP level was within normal limits in younger group. Figure. No caption available. Conclusions: Resistant hypertension could be the clinical manifestation of various diseases with different etiology. Resistant hypertension in older patients can be a clinical presentation of HFpEF and should be investigated and treated accordingly. Because of one-center results and limited number of patients, further studies are needed.