Vol. 51 | No. 1 | January-June 2023 Back

Open Access

Clinical Profile and Management Approach of Patients Diagnosed with Resistant Hypertension in the Philippine General Hospital

Gelza Mae A. Zabat, Janellen L. Quiambao, Ela C. Villaverde, Christine Lorraine D. Balibadlan, Raymond V. Oliva
Jun 2023 DOI 10.69944/pjc.a983c68147

Abstract

INTRODUCTION: Resistant hypertension is blood pressure (BP) that remains above target despite treatment with maximum doses of three antihypertensive drugs, which may include a diuretic. The prevalence of resistant hypertension is unknown, and there are no local studies in the Philippines concerning this condition.

METHODS: A retrospective descriptive cohort study was conducted in the Hypertension Clinic of the Section of Hypertension of the Philippine General Hospital. A total of 51 patients were diagnosed with resistant hypertension, and charts were reviewed and analyzed.

RESULTS: Majority of the patients were female (31 [60.8%]), with a mean age of 56.3 years. All of them presented with symptoms; the most common presenting symptoms were headache, exertional dyspnea, nape pain, dizziness, and easy fatigability. Of the 51 patients, 45% also had diabetes mellitus, 11.8% had dyslipidemia, and 7.8% had a previous history of preeclampsia. Approximately 35% of these patients were smokers. The average BP before referral to the section was 167/94 mm Hg. By this time, most patients will either be on a four-drug regimen (42.1%) or a three-drug regimen (36.8%). The median number of visits in the Hypertension Clinic before control of BP was three follow-ups, with the average BP being 119/71 mm Hg. The regimens of the patients with controlled BP are three-drug combination (36.4%), four-drug combination (36.4%), and five-drug combination (27.3%).

CONCLUSION: Early referral to a hypertension specialist may benefit a patient with resistant hypertension, decreasing the number of follow-up visits to control a patient’s BP. Patients with resistant hypertension may require four- to five-drug regimens, which may be needed to adequately control a patient’s BP.

KEYWORDS: drug combination, elevated blood pressure, hypertension, resistant hypertension

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