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Findings Published in the Journal of Hypertension Show Treatment-Resistant Hypertension Exerts A Serious Emotional Toll on Patients.

-- Global Survey Demonstrates Critical Need for Increased Collaboration Between Patients and Physicians to Cope with Treatment-Resistant Hypertension

ERLANGEN, Germany, March 4, 2013 /PRNewswire/ -- Results from a large, international survey on treatment-resistant hypertension (rHTN) found that rHTN has a significant impact on patients' quality of life, negatively impacting mood, work and interpersonal relationships. These findings underscore the critical need to more aggressively educate and empower patients and healthcare professionals to help improve control of rHTN. The survey results were published today in the Journal of Hypertension, the official journal of the International Society of Hypertension and the European Society of Hypertension.

Nearly 120 million people worldwide suffer with rHTN, defined as persistently high blood pressure despite treatment with three or more antihypertensive medications.[1],[2][sup.]Treatment-resistant hypertension is caused by multiple factors including lifestyle and underlying conditions, making its diagnosis and management complex, often requiring a multi-disciplinary approach. Patients with rHTN have a three-fold increase in risk of cardiovascular events, including stroke and heart attack, compared to individuals with controlled hypertension.[3]

To better understand this growing population of at-risk patients, Power Over Pressure, a coalition of global hypertension experts endorsed by the American Society of Hypertension and the European Society of Hypertension, commissioned a global study of uncontrolled hypertension patients, half of whom are treatment-resistant. The survey was conducted online in October, 2011 by Harris Interactive among more than 4,500 uncontrolled hypertension patients in Brazil, France, Germany, Italy, Japan, Spain, the United Kingdom, and the United States.

The survey results showed that people with rHTN are very worried about their overall health. Although most people with rHTN reported being under the care of a general practitioner or cardiologist, two-thirds (67 percent) described their overall health as 'fair or poor'. Patients with rHTN said their blood pressure negatively affects their mood (25 percent), sex life (32 percent), and self-esteem (29 percent). Furthermore, 75 percent of people with rHTN indicated that their quality of life would greatly improve if they could get their blood pressure under control.

"Treatment-resistant hypertension takes a significant toll on a person's quality of life, both physically and emotionally. It can be a very frustrating condition to manage for both patients and their physicians," said Roland Schmieder, M.D., professor of internal medicine, nephrology and hypertension and head of the clinical research center hypertension and vascular medicine at the department of nephrology and hypertension of the University Hospital Erlangen in Germany, and co-chair of the Power Over Pressure Steering Committee. "While physicians are understandably concerned about the physical complications of this severe form of hypertension, these results highlight the need to also consider the emotional impact of the disease. Through enhanced patient and physician dialogue and collaboration, as well as appropriate referrals to hypertension specialists, we can gain better control of this disease and help improve patient outcomes."

For patients with rHTN, the condition is clearly their most serious health concern and it has a profound impact on their everyday lives. Fifty-seven percent of patients with rHTN reported that they are often anxious about managing their blood pressure and 41 percent reported feeling powerless to control their high blood pressure. When asked about their doctor's attitude about their hypertension, significantly more people with rHTN (32 percent) felt that their doctor underestimates how much their high blood pressure impacts their life.

Managing rHTN presents a substantial challenge for physicians; the publication in the Journal of Hypertension cites results from the Supporting Hypertension Awareness and Research Europe-wide (SHARE) physician survey showed that, on average, only half (52.6 percent) of their patients were attaining European Society of Hypertension-European Society of Cardiology blood pressure targets, and three-quarters said that it is a challenge to get their patients to these blood pressure targets in clinical practice. Survey respondents indicated that patient-related factors, such as nonadherence, were the greatest obstacles to blood pressure control, but physician-related factors also played a role in blood pressure control. For example, the survey demonstrated that physicians often fail to intensify therapy when patients are not meeting established blood pressure targets. The Power Over Pressure survey findings help to increase understanding of patient perceptions about living with rHTN, which in turn may assist healthcare providers in partnering more effectively with their patients to improve outcomes.

"Achieving blood pressure control in these difficult-to-treat patients can have a substantial positive impact on their emotional well being in addition to improving their physical health," said Professor Schmieder. "In recent years, our understanding of treatment-resistant hypertension has increased and new therapeutic approaches are providing the potential to improve patient outcomes. The Power Over Pressure campaign is committed to advancing the management and treatment of this growing, high-risk patient population."

About Treatment-Resistant Hypertension

Hypertension (HTN) is a substantial and growing global health problem, affecting 972 million people worldwide.[4] Despite focused efforts and the introduction of multiple new therapies, a substantial portion of HTN patients lack blood pressure control. Treatment-resistant high blood pressure is an especially dangerous chronic disease because of its association with increased cardiovascular risk, including stroke and heart attack, as well as heart failure and kidney disease.[5] Research suggests that 28 percent of treated hypertensive individuals are considered resistant to treatment.[6]

About the Survey

This survey was conducted online October 4-25, 2011 by Harris Interactive and sponsored by Medtronic, Inc. among 4,574 adults aged 18+ who self-report that they have been diagnosed with uncontrolled (n=2,649) or resistant (n=1,925) hypertension within the United States (n=571 uncontrolled, n=238 resistant), United Kingdom (n=220 uncontrolled, n=318 resistant), France (n=214 uncontrolled, n=210 resistant), Germany (n=291 uncontrolled, n=218 resistant), Italy (n=393 uncontrolled, n=221 resistant), Spain (n=280 uncontrolled, n=257 resistant), Brazil (n=376 uncontrolled, n=213 resistant), and Japan (n=304 uncontrolled, n=250 resistant).

About Power Over Pressure

Developed by a team of global experts in hypertension, Power Over Pressure is a global campaign to advance the diagnosis and management of treatment-resistant hypertension. provides healthcare professionals with the latest information about rHTN, including downloadable materials that enable broader education about the disease. This free resource was designed to be the one-stop comprehensive digital location for everything related to rHTN, including educational guides, slide sets, and other valuable tools to help physicians more quickly identify people with treatment-resistant hypertension and optimize their care plans through current and emerging treatment approaches. For more information, please visit

Power Over Pressure is supported by Medtronic, Inc., the global leader in medical technology.

[1] Egan, Brent M., et al. "Uncontrolled and Apparent Treatment Resistant Hypertension in the United States, 1988-2008."Circulation 2011;124:1046-1058..

[2] Hypertension and cardiovascular disease.World Heart Federation. 2011. cardiovascular-health/cardiovascular- disease-risk-factors/hypertension/. Accessed January 23, 2012.

[3] Doumas, Michael, et al. "Benefits from Treatment and Control of Patients with Resistant Hypertension." International Journal of Hypertension 2011 (2011) Article ID 318549, 8 pages, 2011. doi:10.4061/2011/318549.

[4] Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365:217-223.

[5] Persell, Stephen D. "Prevalence of Resistant Hypertension in the United States, 2003-2008." Hypertension 57.6 (2011): 1076-1080.

[6] Calhoun, David A., et al. "Resistant Hypertension: Diagnosis, Evaluation, and Treatment A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research." Circulation 117. 25 (2008): e510-e526.
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Publication:PR Newswire Europe
Geographic Code:4EUGE
Date:Mar 4, 2013
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