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We performed for the first time a meta-analysis, by using published data or available data from published databases, on the risk of HF in ARH. Patients with ARH (24-h BP\u2009\u2265\u2009130\/80\u2009mmHg during treatment with \u22653 drugs) were compared with those with controlled hypertension (CH, clinic BP\u2009&lt;\u2009140\/90\u2009mmHg and 24-h BP\u2009&lt;\u2009130\/80\u2009mmHg regardless of the number of drugs used), white coat uncontrolled resistant hypertension (WCURH, clinic BP\u2009\u2265\u2009140\/90\u2009mmHg and 24-h BP\u2009&lt;\u2009130\/80\u2009mmHg in treated patients) and ambulatory nonresistant hypertension (ANRH, 24-h BP\u2009\u2265\u2009130\/80\u2009mmHg during therapy with \u22642 drugs). We identified six studies\/databases including 21,365 patients who experienced 692 HF events. When ARH was compared with CH, WCURH, or ANRH, the overall adjusted hazard ratio for HF was 2.32 (95% confidence interval (CI) 1.45\u20133.72), 1.72 (95% CI 1.36\u20132.17), and 2.11 (95% CI 1.40\u20133.17), respectively, (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). For some comparisons a moderate heterogeneity was found. Though we did not find variables that could explain the heterogeneity, sensitivity analyses demonstrated that none of the studies had a significant influential effect on the overall estimate. When we evaluated the potential presence of publication bias and small-study effect and adjusted for missing studies identified by Duval and Tweedie\u2019s method the estimates were slightly lower but remained significant. This meta-analysis shows that treated hypertensive patients with ARH are at approximately twice the risk of developing HF than other ambulatory BP phenotypes.<\/jats:p>","DOI":"10.1038\/s41440-024-01632-8","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T10:06:43Z","timestamp":1710410803000},"page":"1235-1245","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk of heart failure in ambulatory resistant hypertension: a meta-analysis of observational studies"],"prefix":"10.1038","volume":"47","author":[{"given":"Francesca","family":"Coccina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil F.","family":"Salles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 R.","family":"Banegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n C.","family":"Hermida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Bastos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia R. 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