How common is Resistant hypertension
Although not representing typical office practices, the data from the Anti-hypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) provides an estimate of the prevalence of RH in the community setting. In ALLHAT, 34% of the study participants had BP >140/90 mostly on two medications, with 27% requiring three or more medications. Based on the 5-year observations in ALLHAT, the incidence of RH was approximately 15%. In the Controlled ONset Verapamil INvestigation of Cardiovascular End Points (CONVINCE) study, 18% of the patients had a BP level >140/90 mm Hg on three or more medications.
Patients with diabetes are more resistant to antihypertensive drugs than nondiabetic subjects are, so they will typically require more antihypertensive drugs to achieve goal BP.