{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:00:18Z","timestamp":1794261618151,"version":"4.9.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients with apparent treatment\u2010resistant hypertension (aTRH) are at increased risk of end\u2010organ damage and cardiovascular events. Little is known about the effects of blood pressure (BP) control in this population. Using a national claims database integrated with electronic medical records, the authors evaluated the relationships between uncontrolled BP (UBP; \u2265130\/80\u00a0mmHg) or controlled BP (CBP; &lt;130\/80\u00a0mmHg) and risk of major adverse cardiovascular events plus (MACE+; stroke, myocardial infarction, heart failure requiring hospitalization) and end\u2010stage renal disease (ESRD) in adult patients with aTRH (taking \u22653 antihypertensive medication classes concurrently within 30 days between January 1, 2015 and June 30, 2021). MACE+ components were also evaluated separately. Multivariable regression models were used to adjust for baseline differences in demographic and clinical characteristics, and sensitivity analyses using CBP\u00a0&lt;140\/90\u00a0mmHg were conducted. Patients with UBP (<jats:italic>n<\/jats:italic>\u00a0=\u00a022\u00a0333) were younger and had fewer comorbidities at baseline than those with CBP (<jats:italic>n<\/jats:italic>\u00a0=\u00a011\u00a0427). In the primary analysis, which adjusted for these baseline differences, UBP versus CBP patients were at an 8% increased risk of MACE+ (driven by a 31% increased risk of stroke) and a 53% increased risk of ESRD after 2.7 years of follow\u2010up. Greater MACE+ (22%) and ESRD (98%) risk increases with UBP versus CBP were seen in the sensitivity analysis. These real\u2010world data showed an association between suboptimal BP control in patients with aTRH and higher incidence of MACE+ and ESRD linked with UBP despite the use of multidrug regimens. Thus, there remains a need for improved aTRH management.<\/jats:p>","DOI":"10.1111\/jch.14701","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T06:18:32Z","timestamp":1689661112000},"page":"737-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Association of uncontrolled blood pressure in apparent treatment\u2010resistant hypertension with increased risk of major adverse cardiovascular events plus"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1183-1267","authenticated-orcid":false,"given":"George","family":"Bakris","sequence":"first","affiliation":[{"name":"University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Chen","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia K.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-1897","authenticated-orcid":false,"given":"Veronica","family":"Ashton","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Haskell","sequence":"additional","affiliation":[{"name":"Janssen Research &amp; Development, LLC Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukul","family":"Singhal","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000084"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19043"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.230"},{"key":"e_1_2_13_5_1","volume-title":"About Multiple Cause of Death, 1999\u20132019. In: CDC WONDER Online Database","author":"National Center for Health Statistics","year":"2021"},{"key":"e_1_2_13_6_1","unstructured":"Hypertension Cascade: Hypertension Prevalence Treatment and Control Estimates Among US Adults Aged 18 Years and Older Applying the Criteria From the American College of Cardiology and American Heart Association's 2017 Hypertension GuidelineNHANES 2017\u20102020.Centers for Disease Control and Prevention (CDC). May 12 2023. Accessed July 10 2023.https:\/\/millionhearts.hhs.gov\/data-reports\/hypertension-prevalence.html"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.006"},{"key":"e_1_2_13_8_1","first-page":"503","article-title":"Joint National Committee. JNC8 guidelines for the management of hypertension in adults","volume":"90","author":"Armstrong C","year":"2014","journal-title":"Am Fam Physician"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12237"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S009"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000001940"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15199"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2025845"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000222373.59104.3d"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.07720"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000195"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15026"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-020-01206-x"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2015.61"},{"key":"e_1_2_13_22_1","first-page":"S21","article-title":"Resistant hypertension: current status, future challenges","volume":"5","author":"Hajizadeh N","year":"2014","journal-title":"Int J Prev Med"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1315-0"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017890"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01156-8"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14739-3"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.142"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-022-00749-y"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2014.03.003"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.923"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.13422"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.11.016"}],"container-title":["The Journal of Clinical Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.14701","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T08:52:09Z","timestamp":1696323129000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jch.14701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,17]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/jch.14701"],"URL":"https:\/\/doi.org\/10.1111\/jch.14701","archive":["Portico"],"relation":{},"ISSN":["1524-6175","1751-7176"],"issn-type":[{"value":"1524-6175","type":"print"},{"value":"1751-7176","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,17]]},"assertion":[{"value":"2023-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}