Diagnosis and treatment of resistant hypertension.


Hypertension resistant to lifestyle interventions and antihypertensive medications is a common problem encountered by physicians in everyday practice. It is most often defined as a blood pressure remaining ≥ 140/90 mmHg despite the regular intake of at least three drugs lowering blood pressure by different mechanisms, one of them being a diuretic. It now appears justified to include, unless contraindicated or not tolerated, a blocker of the renin-angiotensin system and a calcium channel blocker in this drug regimen, not only to gain antihypertensive efficacy, but also to prevent or regress target organ damage and delay the development of cardiorenal complications. A non-negligible fraction of treatment-resistant hypertension have normal "out of office" blood pressures. Ambulatory blood pressure monitoring and/or home blood pressure recording should therefore be routinely performed to identify patients with true resistant hypertension, i.e. patients who are more likely to benefit from treatment intensification.

DOI: 10.3109/08037051.2013.854946

Cite this paper

@article{Waeber2014DiagnosisAT, title={Diagnosis and treatment of resistant hypertension.}, author={Bernard Waeber and Massimo Volpe and Lu{\'i}s Miguel Ruilope and Roland E Schmieder}, journal={Blood pressure}, year={2014}, volume={23 4}, pages={193-9} }