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Updated: Sep 27, 2026

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

[When blood pressure control is a problem. Refractory hypertension is rare]

E Offers1, R Kolloch

  • 1Med. Klinik, Krankenanstalten Gilead, Akadem. Lehrkrankenhaus der Westfälischen Wilhelms-Univ. Münster, Bielefeld. Offers@medklinik.gilead.de

MMW Fortschritte Der Medizin
|January 22, 2003
PubMed

Insights

Refractory hypertension is diagnosed when three different medications fail to control blood pressure. Differentiating true refractory cases from pseudo-refractory hypertension is crucial for effective treatment.

Area of Science:

  • Cardiology
  • Pharmacology

Context:

  • Hypertension management presents challenges, particularly with treatment-resistant cases.
  • Refractory hypertension affects an estimated 2-5% of hypertensive patients.
  • Distinguishing true refractory hypertension from pseudo-refractory forms is essential for appropriate patient care.

Purpose:

  • To define refractory hypertension and outline diagnostic and therapeutic considerations.
  • To differentiate true refractory hypertension from pseudo-refractory hypertension.
  • To guide management strategies for patients with difficult-to-control high blood pressure.

Summary:

  • Refractory hypertension is defined as blood pressure remaining above 140/90 mmHg despite maximal doses of three different antihypertensive agents, including a diuretic, sympathetic blocker, and vasodilator.
  • Pseudo-refractory hypertension can result from various factors, including inadequate therapy, drug interactions, or secondary causes.
  • Management involves optimizing diuretic therapy, maximizing antihypertensive doses, and considering additional agents like minoxidil in combination therapy.

Impact:

  • Improved diagnostic accuracy for refractory hypertension.
  • Enhanced therapeutic strategies for patients with resistant high blood pressure.
  • Reduced cardiovascular risk in a challenging patient population.

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