{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:46:31Z","timestamp":1780436791117,"version":"3.54.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Hong Kong College of Family Physicians","award":["HKCFP Research Fellowship"],"award-info":[{"award-number":["HKCFP Research Fellowship"]}]},{"name":"Hong Kong College of Family Physicians","award":["HKCFP Research Fellowship"],"award-info":[{"award-number":["HKCFP Research Fellowship"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypertension (HT) is a major public health problem globally, and it is the commonest chronic disease with a prevalence of 27% among people aged 15 years or above in Hong Kong. There is emerging literature confirmed that patients with resistant hypertension (RHT) give its increased risk for adverse clinical outcomes and higher rate of documented target organ damage. This study aims to identify the prevalence of RHT among Chinese hypertensive patients managed in public primary care setting of Hong Kong and exploring its associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This is a cross-sectional descriptive study. Chinese hypertensive patients aged 30 or above with regular follow-up between 1st July 2019 and 30th June 2020 in 10 public primary care clinics under the Hospital Authority of Hong Kong were included. Demographic data, clinical parameters and drug profile of patients were retrieved from its computerized record system. The prevalence of RHT was identified and the associated risk factors of RHT were explored by multivariate logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 538 sampled Chinese hypertensive patients, the mean age was 67.4\u2009\u00b1\u200911.5 years old, and 51.9% were female. The mean duration of hypertension was 10.1\u2009\u00b1\u20096.4 years, with a mean systolic and diastolic blood pressure of 128.8\u2009\u00b1\u200912.3 and 72.9\u2009\u00b1\u200910.8 mmHg respectively. 40 out of 538 patients were found to have RHT, giving an overall prevalence of 7.43%. Four factors were found to be associated with increased risk of RHT, in ascending order of odds ratio: duration of hypertension (OR 1.08), male gender (OR 2.72), comorbid with type 2 diabetes mellitus (T2DM, OR 2.99), and congestive heart failure (CHF, OR 5.39).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of RHT among Chinese hypertensive patients in primary care setting of Hong Kong is 7.43%. RHT is more common in male patients, patients with longer duration of hypertension, concomitant T2DM and CHF. Clinicians should be vigilant when managing these groups of patients and provide aggressive treatment and close monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-024-02366-9","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T02:01:23Z","timestamp":1713492083000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and associated risk factors of resistant hypertension among Chinese hypertensive patients in primary care setting"],"prefix":"10.1186","volume":"25","author":[{"given":"Kilpatrick Kiupak","family":"Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lapkin","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarence Chuenming","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimchu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine Xiarui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"2366_CR1","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1001\/jama.289.18.2363","volume":"289","author":"K Wolf-Maier","year":"2003","unstructured":"Wolf-Maier K, Cooper RS, Banegas JR, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289:2363\u20139.","journal-title":"JAMA"},{"issue":"1","key":"2366_CR2","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1161\/CIR.0b013e318245fac5","volume":"125","author":"VL Roger","year":"2012","unstructured":"Roger VL, Go AS, Lloyd-Jones DM, et al. Heart Disease and Stroke Statistics\u20132012 update: a Report from the American Heart Association. Circulation. 2012;125(1):e2\u2013220.","journal-title":"Circulation"},{"key":"2366_CR3","volume-title":"Report on Population Health Survey 2014\/15","author":"Department of Health","year":"2017","unstructured":"Department of Health. Report on Population Health Survey 2014\/15. Hong Kong SAR: Department of Health; 2017."},{"key":"2366_CR4","first-page":"17","volume":"32","author":"YYC Lo","year":"2010","unstructured":"Lo YYC, Lam CLK, Lam TP, et al. Hong Kong primary care morbidity Survey 2007\u20132008. Hong Kong Practitioner. 2010;32:17\u201326.","journal-title":"Hong Kong Practitioner"},{"key":"2366_CR5","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1038\/sj.jhh.1000426","volume":"11","author":"P Marques-Vidal","year":"1997","unstructured":"Marques-Vidal P, Toumilehto J. Hypertension awareness, treatment and control in the community: is the \u2018rule of halves\u2019 still valid? J Hum Hypertens. 1997;11:213\u201320.","journal-title":"J Hum Hypertens"},{"key":"2366_CR6","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1016\/S0140-6736(08)60655-8","volume":"371","author":"CMM Lawes","year":"2001","unstructured":"Lawes CMM, Hoorn SV, Rodgers A. Global burden of blood pressure related disease. Lancet. 2001;371:1513\u20138.","journal-title":"Lancet"},{"key":"2366_CR7","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/S0140-6736(04)17018-9","volume":"364","author":"S Yusuf","year":"2004","unstructured":"Yusuf S, Hawken S, \u00d4unpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937\u201352.","journal-title":"Lancet"},{"issue":"6","key":"2366_CR8","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1161\/01.HYP.0000107251.49515.c2","volume":"42","author":"AV Chobanian","year":"2003","unstructured":"Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206\u201352.","journal-title":"Hypertension"},{"key":"2366_CR9","unstructured":"National Institute for Health and Clinical Excellence. Hypertension in Adults: Diagnosis and Management. NICE Guideline 136. 2019. https:\/\/www.nice.org.uk\/guidance\/ng136"},{"issue":"10","key":"2366_CR10","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1097\/00004872-200310000-00001","volume":"21","author":"R Cifkova","year":"2003","unstructured":"Cifkova R, Erdine S, Fagard R, et al. ESH\/ESC Hypertension Guidelines Committee: practice guidelines for primary care physicians: 2003 ESH\/ESC hypertension guidelines. J Hypertens. 2003;21(10):1779\u201386.","journal-title":"J Hypertens"},{"key":"2366_CR11","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1038\/jhh.2014.73","volume":"29","author":"DJ Hyman","year":"2015","unstructured":"Hyman DJ, Pavlik V. Medication adherence and resistant hypertension. J Hum Hypertens. 2015;29:213\u20138.","journal-title":"J Hum Hypertens"},{"key":"2366_CR12","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1161\/HYPERTENSIONAHA.110.168948","volume":"57","author":"A de la Sierra","year":"2011","unstructured":"de la Sierra A, Segura J, Banegas JR, et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011;57:898\u2013902.","journal-title":"Hypertension"},{"issue":"12","key":"2366_CR13","doi-asserted-by":"publisher","first-page":"e007365","DOI":"10.1161\/JAHA.117.007365","volume":"6","author":"P Armario","year":"2017","unstructured":"Armario P, Calhoun DA, Oliveras A, et al. Prevalence and clinical characteristics of refractory hypertension. J Am Heart Assoc. 2017;6(12):e007365.","journal-title":"J Am Heart Assoc"},{"key":"2366_CR14","doi-asserted-by":"publisher","first-page":"j3984","DOI":"10.1136\/bmj.j3984","volume":"358","author":"SJ Sinnott","year":"2017","unstructured":"Sinnott SJ, Smeeth L, Williamson E, et al. Trends for prevalence and incidence of resistant hypertension: population based cohort study in the UK 1995\u20132015. BMJ. 2017;358:j3984.","journal-title":"BMJ"},{"key":"2366_CR15","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/1471-2296-15-131","volume":"15","author":"YC Chia","year":"2014","unstructured":"Chia YC, Ching SM. Prevalence and predictors of resistant hypertension in a primary care setting: a cross-sectional study. BMC Fam Pract. 2014;15:131.","journal-title":"BMC Fam Pract"},{"key":"2366_CR16","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s40885-016-0043-z","volume":"22","author":"KN Lee","year":"2016","unstructured":"Lee KN, Na JO, Choi CU, Lim HE, Kim JW, Kim EJ, Rha SW, Seo HS, Oh DJ, Park CG. Prevalence and characteristics of resistant hypertension at primary clinics in Korea: a nationwide cross-sectional study. Clin Hypertens. 2016;22:4.","journal-title":"Clin Hypertens"},{"issue":"11","key":"2366_CR17","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1016\/j.jash.2016.08.008","volume":"10","author":"L Holmqvist","year":"2016","unstructured":"Holmqvist L, Bostr\u00f6m KB, Kahan T, et al. Prevalence of treatment-resistant hypertension and important associated factors-results from the Swedish Primary Care Cardiovascular Database. J Am Soc Hypertens. 2016;10(11):838\u201346.","journal-title":"J Am Soc Hypertens"},{"issue":"3","key":"2366_CR18","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/s40292-018-0268-x","volume":"25","author":"S Romano","year":"2018","unstructured":"Romano S, Idolazzi C, Fava C, et al. Prevalence and comorbidities of resistant hypertension: a Collaborative Population-based observational study. High Blood Press Cardiovasc Prev. 2018;25(3):295\u2013301.","journal-title":"High Blood Press Cardiovasc Prev"},{"issue":"12","key":"2366_CR20","doi-asserted-by":"publisher","first-page":"e114958","DOI":"10.1371\/journal.pone.0114958","volume":"9","author":"C-N Jin","year":"2014","unstructured":"Jin C-N, Liu M. The prevalence and prognosis of resistant hypertension in patients with heart failure. PLoS ONE. 2014;9(12):e114958.","journal-title":"PLoS ONE"},{"key":"2366_CR21","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","volume":"398","author":"NCD Risk Factor Collaboration","year":"2021","unstructured":"NCD Risk Factor Collaboration. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398:957\u201380.","journal-title":"Lancet"},{"issue":"5","key":"2366_CR22","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1177\/1358863X12450094","volume":"17","author":"MS Zhou","year":"2012","unstructured":"Zhou MS, Schulman IH, Zeng Q. Link between the renin-angiotensin system and insulin resistance: implications for cardiovascular disease. Vasc Med. 2012;17(5):330\u201341.","journal-title":"Vasc Med"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-024-02366-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-024-02366-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-024-02366-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T02:01:43Z","timestamp":1713492103000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-024-02366-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2366"],"URL":"https:\/\/doi.org\/10.1186\/s12875-024-02366-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3114903\/v1","asserted-by":"object"}]},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]},"assertion":[{"value":"27 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Research Ethics Committee of Kowloon Central Cluster of Hospital Authority of Hong Kong. (Approval number: KC\/KE-20-0260\/ER-2). This was a cross sectional descriptive study involving clinical data retrieved from Computerized Medical System (CMS), written informed consent from participants were exempted by Research Ethics Committee of Kowloon Central Cluster of Hospital Authority of Hong Kong. All methods were carried out in accordance with the relevant guidelines and regulations,","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"120"}}