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div>9 Among studies in larger cohorts that examine the epidemiologic characteristics of resistant hypertension, two included patients visiting a tertiary hypertension facility for the first time and showed the selleck inhibitor prevalence to be 11%10 and 21%,11 respectively. Perhaps the situation in the general hypertensive population is best reflected in a recent retrospective study that examined records of an electronic medical database including data from about 100 practice sites and 9700 clinicians (mostly primary care specialists). In this study, among 29,474 adult patients with a diagnosis of hypertension who completed a yearly follow-up within the system, a diagnosis of resistant hypertension based on the formal definition could be made in about 9%. Interestingly, another 6% of the population could not achieve adequate control despite taking 3, 4, or more drugs in the absence of a thiazide diuretic.12 Overall, studies of this type provide important information, but suffer from several limitations, including the retrospective type of the analysis and the fact that relevant data were based on simple clinical readings and, therefore, no distinction can be made between pseudoresistance and true resistance, as described below. Data from major population studies on prevalence, awareness, treatment, and control of hypertension can also be used to approximate the prevalence of resistant hypertension. In the United States, the series of the National Health and Nutrition check details Examination Surveys (NHANES) suggest that the net and age-adjusted prevalence of hypertension has been constantly increasing through the past decades, but the proportions of adults with hypertension who are aware of their disease, receive antihypertensive treatment, and keep their BP under control have also considerably improved from 1976 to 2000.13,14 Recent data suggest that about 37% of the total hypertensive population and 58% of patients taking antihypertensive GBA3 medication achieve BP levels <140/90 mm Hg.14 However, control rates among high-risk individuals, ie, patients with diabetes and CKD, are much lower, especially with application of the more strict BP goal of 130/80?mm?Hg for these groups.14�C17 Of note, either in the general hypertensive population or in patients with diabetes or CKD, inadequate control of systolic BP (SBP) is the main culprit responsible for poor control rates.14,17,18 Similar data from Europe suggest a much worse situation, with control rates among treated hypertensives ranging between 19% and 40% in 5 countries examined in large surveys.19 These low rates of control suggest that resistant hypertension is not uncommon, but accurate estimations cannot be made from such studies since they do not provide information on the number, type, and dosage of antihypertensive agents used.