• Cormac Kennedy, Osama Ali, Richard Farnan, John Stinson, Ahmed Gabr, Mary Hall, Patricia O'Connor, Martina Hennessy, and Michael Barry.
• Department of Pharmacology and Therapeutics, Trinity College, Dublin 8, Ireland. kennec30@tcd.ie.
• Ir J Med Sci. 2022 Dec 1; 191 (6): 254925572549-2557.

BackgroundThe management of hypertension is primarily performed in primary care settings in many health systems. However, two groups of patients often require specialist input: patients with resistant hypertension (RH) and young adults with hypertension.AimsTo elucidate these groups by examining the characteristics of patients attending an Irish hypertension service, thus informing future management of hypertension.MethodsPatients were recruited at consecutive hypertension clinics at St James Hospital, Dublin from July to September 2019. Following patient consent, patient data were recorded to identify patient characteristics as well as the results of investigations, blood pressure (BP) measurements and the anti-hypertensive treatment of the study participants which were then analysed.ResultsTwo hundred thirty-six patients were included in the study. Compared to those without RH, the RH group were more likely to be obese (OR 2.59 [95% CI 1.06 to 6.33]), to have cardiovascular disease (OR 3.07 [95% CI 1.56 to 6.02]) and to have a non-dipping BP pattern (OR 3.86 [95% CI 1.57 to 9.47]). Young adults comprised 27% of the cohort. Forty-seven percent of these patients were obese, 15.9% had hypertension in pregnancy and 22.2% had chronic headaches. Despite being prescribed less anti-hypertensives (1.41 vs 2.28; p < 0.05), the majority of young patients had a BP less than 140/90 mmHg, comparing favourably with older patients (OR 2.25 [95% CI 1.20 to 4.27]).ConclusionThis contemporary study highlights the high prevalence of obesity among RH patients and young adults with hypertension. Findings suggest that programs to combat hypertension must include interventions to address obesity.© 2021. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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