{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T12:51:31Z","timestamp":1769691091185,"version":"3.49.0"},"reference-count":25,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":65,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To evaluate the prognostic importance of resistant hypertension (RHT) for the development of complications in a cohort of individuals with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A total of 646 patients had the diagnosis of apparent treatment-resistant hypertension (aRHT) based on mean office blood pressure (BP) levels during the 1st year of follow-up. They were reclassified as white-coat\/controlled or true\/uncontrolled RHT according to 24-h ambulatory BP monitoring (ABPM), using the traditional BP cutoffs and the new 2017 American College of Cardiology (ACC)\/American Heart Association (AHA) criteria. Multivariate Cox analyses examined the associations between RHT diagnoses and the occurrence of microvascular and cardiovascular complications and all-cause and cardiovascular mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>During a median follow-up of 10 years, 177 patients had a cardiovascular event (145 major ones); 222 patients died (101 from cardiovascular diseases); 200 had a renal event; 156 had a retinopathy event; and 174 patients had a neuropathy event. In relation to non-RHT individuals, aRHT (present in 44.6% and 50% by the traditional and new criteria, respectively) predicted all cardiovascular and mortality outcomes, with hazard ratios (HRs) between 1.64 and 2.16, but none of the microvascular outcomes. True RHT increased the HRs (from 1.81 to 2.25) and additionally predicted renal outcomes. White-coat\/controlled RHT implied an increased risk (HRs 1.33\u20131.86) that was intermediate between non-RHT and true RHT individuals. Classifications using the traditional and the new ACC\/AHA criteria were equivalent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In patients with type 2 diabetes, the presence of aRHT implied an increased risk of cardiovascular and mortality outcomes, and classification based on ABPM predicted renal outcomes and improved cardiovascular\/mortality risk stratification.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc19-1534","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T01:45:19Z","timestamp":1571276719000},"page":"219-227","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":16,"title":["Prognostic Importance of Resistant Hypertension in Patients With Type 2 Diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study"],"prefix":"10.2337","volume":"43","author":[{"given":"Claudia R.L.","family":"Cardoso","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie C.","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Bacan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayane S.","family":"Ata\u00edde","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa K.C.","family":"Gorgonio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6318-7077","authenticated-orcid":false,"given":"Gil F.","family":"Salles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2019,10,16]]},"reference":[{"key":"2022031223540171300_B1","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1161\/HYP.0000000000000084","article-title":"Resistant hypertension: detection, evaluation, and management: a scientific statement from the American Heart Association","volume":"72","author":"Carey","year":"2018","journal-title":"Hypertension"},{"key":"2022031223540171300_B2","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1161\/CIRCULATIONAHA.112.097345","article-title":"Resistant hypertension: incidence, prevalence, and prognosis","volume":"125","author":"Pimenta","year":"2012","journal-title":"Circulation"},{"key":"2022031223540171300_B3","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1161\/CIRCULATIONAHA.111.068064","article-title":"Incidence and prognosis of resistant hypertension in hypertensive patients","volume":"125","author":"Daugherty","year":"2012","journal-title":"Circulation"},{"key":"2022031223540171300_B4","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.jash.2014.03.003","article-title":"Apparent treatment-resistant hypertension and risk for stroke, coronary heart disease, and all-cause mortality","volume":"8","author":"Irvin","year":"2014","journal-title":"J Am Soc Hypertens"},{"key":"2022031223540171300_B5","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/ki.2015.142","article-title":"Comparative risk of renal, cardiovascular, and mortality outcomes in controlled, uncontrolled resistant, and nonresistant hypertension","volume":"88","author":"Sim","year":"2015","journal-title":"Kidney Int"},{"key":"2022031223540171300_B6","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/HJH.0000000000001561","article-title":"Cardiovascular outcome in treatment-resistant hypertension: results from the Swedish Primary Care Cardiovascular Database (SPCCD)","volume":"36","author":"Holmqvist","year":"2018","journal-title":"J Hypertens"},{"key":"2022031223540171300_B7","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1056\/NEJMoa1008862","article-title":"Diabetes mellitus, fasting glucose, and risk of cause-specific death","volume":"364","author":"Rao Kondapally Seshasai","year":"2011","journal-title":"N Engl J Med"},{"key":"2022031223540171300_B8","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12916-019-1313-x","article-title":"Is resistant hypertension an independent predictor of all-cause mortality in individuals with type 2 diabetes? A prospective cohort study","volume":"17","author":"Solini","year":"2019","journal-title":"BMC Med"},{"key":"2022031223540171300_B9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.117.006745","article-title":"Resistant hypertension, time-updated blood pressure values and renal outcome in type 2 diabetes mellitus","volume":"6","author":"Viazzi","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2022031223540171300_B10","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1159\/000488255","article-title":"Apparent treatment resistant hypertension, blood pressure control and the progression of chronic kidney disease in patients with type 2 diabetes","volume":"43","author":"Viazzi","year":"2018","journal-title":"Kidney Blood Press Res"},{"key":"2022031223540171300_B11","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1097\/HJH.0000000000000355","article-title":"Prognostic impact from clinic, daytime, and night-time systolic blood pressure in nine cohorts of 13,844 patients with hypertension","volume":"32","author":"Roush","year":"2014","journal-title":"J Hypertens"},{"key":"2022031223540171300_B12","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMoa1712231","article-title":"Relationship between clinic and ambulatory blood-pressure measurements and mortality","volume":"378","author":"Banegas","year":"2018","journal-title":"N Engl J Med"},{"key":"2022031223540171300_B13","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J Hypertens"},{"key":"2022031223540171300_B14","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1016\/j.jacc.2017.11.005","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive Summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022031223540171300_B15","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1097\/HJH.0b013e328364103f","article-title":"Prognostic impact of clinic and ambulatory blood pressure components in high-risk type 2 diabetic patients: the Rio de Janeiro Type 2 Diabetes Cohort Study","volume":"31","author":"Salles","year":"2013","journal-title":"J Hypertens"},{"key":"2022031223540171300_B16","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00592-014-0592-0","article-title":"Prognostic importance of baseline and serial glycated hemoglobin levels in high-risk patients with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study","volume":"52","author":"Cardoso","year":"2015","journal-title":"Acta Diabetol"},{"key":"2022031223540171300_B17","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1007\/s00125-015-3658-9","article-title":"Increased aortic stiffness predicts future development and progression of peripheral neuropathy in patients with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study","volume":"58","author":"Cardoso","year":"2015","journal-title":"Diabetologia"},{"key":"2022031223540171300_B18","doi-asserted-by":"crossref","first-page":"4867","DOI":"10.1038\/s41598-017-05159-6","article-title":"Predictors of development and progression of retinopathy in patients with type 2 diabetes: importance of blood pressure parameters","volume":"7","author":"Cardoso","year":"2017","journal-title":"Sci Rep"},{"key":"2022031223540171300_B19","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s00125-017-4484-z","article-title":"Aortic stiffness and ambulatory blood pressure as predictors of diabetic kidney disease: a competing risks analysis from the Rio de Janeiro Type 2 Diabetes Cohort Study","volume":"61","author":"Cardoso","year":"2018","journal-title":"Diabetologia"},{"key":"2022031223540171300_B20","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.jdiacomp.2018.05.010","article-title":"Usefulness of the vibration perception thresholds measurement as a diagnostic method for diabetic peripheral neuropathy: results from the Rio de Janeiro type 2 diabetes cohort study","volume":"32","author":"Santos","year":"2018","journal-title":"J Diabetes Complications"},{"key":"2022031223540171300_B21","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.1590\/S0102-311X2008001200030","article-title":"Prevalence of anti-hypertensive treatment adherence in patients with resistant hypertension and validation of three indirect methods for assessing treatment adherence","volume":"24","author":"Bloch","year":"2008","journal-title":"Cad Saude Publica"},{"key":"2022031223540171300_B22","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1161\/HYPERTENSIONAHA.114.03850","article-title":"Treatment-resistant hypertension and the incidence of cardiovascular disease and end-stage renal disease: results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)","volume":"64","author":"Muntner","year":"2014","journal-title":"Hypertension"},{"key":"2022031223540171300_B23","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1097\/HJH.0000000000000221","article-title":"European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring","volume":"32","author":"Parati","year":"2014","journal-title":"J Hypertens"},{"key":"2022031223540171300_B24","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1038\/hr.2010.80","article-title":"Uncontrolled isolated office hypertension is associated with subclinical markers of cardiovascular disease in hypertensive type 2 diabetic patients","volume":"33","author":"Salles","year":"2010","journal-title":"Hypertens Res"},{"key":"2022031223540171300_B25","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1161\/HYPERTENSIONAHA.111.185405","article-title":"Appropriate time interval to repeat ambulatory blood pressure monitoring in patients with white-coat resistant hypertension","volume":"59","author":"Muxfeldt","year":"2012","journal-title":"Hypertension"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc19-1534","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/43\/1\/219\/529864\/dc191534.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/43\/1\/219\/529864\/dc191534.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T03:51:21Z","timestamp":1647143481000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/43\/1\/219\/35871\/Prognostic-Importance-of-Resistant-Hypertension-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,16]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,10,16]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc19-1534","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,16]]}}}