Resistant hypertension: do all definitions describe the same patients?

Resistant hypertension (rh) is defined as blood pressure (bp) that remains ⩾140 and/or 90 mm hg despite therapy with ⩾3 full-dose antihypertensive drugs (classical definition=cd). a definition proposed subsequently (new definition=nd) includes patients requiring ⩾4 drugs irrespective of bp values. we aimed to evaluate whether both definitions characterize the same kind of patients.one hundred and twenty-four consecutively attended patients with rh were classified into two groups according to their bp control: 66 patients had non-controlled bp (all those who met the cd criteria plus a few patients who met the nd criteria); 58 patients had controlled bp (all with rh according to the nd). clinical, laboratory and office bp data were recorded. rh patients with non-controlled bp were more frequently diabetic (72% vs 49%), and had higher plasmatic glucose (149 vs 130 mg dl−1), cholesterol (179 vs 164 mg dl−1), low-density lipoprotein (ldl)-cholesterol (107 vs 95 mg dl−1) and triglyceride (169 vs 137 mg dl−1) levels; p<0.05 for all comparisons. in multivariate logistic regression analysis, the variables that independently associated with non-controlled bp were diabetes (p=0.001) and higher ldl-cholesterol (p=0.007).we conclude that, although both cohorts of patients are phenotypically quite similar, uncontrolled rh patients have higher prevalence of diabetes mellitus and higher ldl-cholesterol levels than controlled rh patients.