Diagnosis and treatment of resistant hypertension. (August 2014)

• Record Type: Journal Article
• Authors: Waeber, Bernard; Volpe, Massimo; Ruilope, Luis M.; Schmieder, Roland E.
• Is Part Of: Blood pressure. Volume 23:Number 4(2014)
• Page Start: 193
• Page End: 199
• Publication Date: 2014-08
• Subjects: Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.3109/08037051.2013.854946
• Languages: English
• ISSNs: 0803-7051

Abstract

<abstract> <title>Abstract</title> <p>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.</p> </abstract>