Differences in blood pressure control based on hypertension subtype in patients with a de novo diagnosis: a retrospective cohort study

Abstract

Abstract The burden of disease due to arterial hypertension (AH) is huge and studies have shown that AH prevalence continues to increase and that control rates are still low, despite public health efforts, lifestyle and pharmacological interventions recommended by guidelines. Therefore, improved therapeutic schemes based on patient´s characteristics are required to achieve blood pressure (BP) goals and thus avoid the impact AH on cardiovascular outcomes. In this real-world study, a cohort of 1397 Latin American subjects with a de novo diagnosis of AH received antihypertensive therapy following current guidelines. Thereafter, they were retrospectively classified by hypertension subtype and BP response was assessed based on whether patients initially received an appropriate treatment according to arterial hemodynamics. The initiation of a proper antihypertensive regimen was statistically significant associated with greater BP control at the follow-up clinical visit, even when the statistical model was adjusted for multiple variables (OR 2.17 CI 1.49–3.15, p value < 0.001). Among patients who were not well controlled, the divergent systolic-diastolic hypertension (SDH-D) subtype was the most frequent (46.7%), and those patients initially had higher BP, cardiac output, total systemic vascular resistance (SVR), and lower arterial compliance. Our findings indicate that the appropriate selection of an antihypertensive treatment guided by the AH subtype is associated with better BP control in patients with newly diagnosed AH.