Resistant Hypertension

Resistant hypertension is defined as uncontrolled blood pressure elevating to approximately (>140/90 mm Hg) after treatment with three or more antihypertensive drugs, such patients are more likely to have a secondary cause and has a high risk of end-organ damage. ACE inhibitor (or an angiotensin receptor blocker), a diuretic and a calcium channel blocker preclude resistant hypertension, which must be ruled out before a diagnosis can be made.

The prognosis of resistant hypertension is not known, however cardiovascular risk is beyond any doubt raised as patients usually have a history of long-standing, severe hypertension sophisticated by multiple different cardiovascular risk factors such as obesity, sleep apnea, diabetes, and chronic renal disorder. The diagnosing of resistant hypertension needs use of excellent blood pressure technique to verify persistently elevated blood pressure levels. Pseudo resistance, including lack of blood pressure management secondary to poor medication adherence or white coat hypertension, should be excluded.

 

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