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Management of refractory hypertension
1Texas Blood Pressure Institute, Dallas Nephrology Associates, University of Texas Southwestern Medical Center, 13154 CoitRoad, Suite 100, Dallas, TX 75240, USA. ramv@dneph.com
American Journal of Therapeutics
|March 12, 2003
Summary
True refractory hypertension is uncommon but requires careful evaluation. Adjusting medication, using diuretics, or potent drugs like hydralazine may be needed, alongside investigating secondary causes.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- True refractory hypertension is rare due to available treatments.
- Hypertension is considered refractory when blood pressure targets aren't met despite standard therapy.
- Proper evaluation is crucial for patients with resistant blood pressure.
Purpose of the Study:
- To outline the evaluation and management of refractory hypertension.
- To emphasize the importance of identifying factors contributing to therapy resistance.
- To guide rational drug selection and consideration of secondary causes.
Main Methods:
- Review of clinical presentation and diagnostic approaches for refractory hypertension.
- Assessment of therapeutic adjustments, including diuretics and potent antihypertensive agents.
- Guidance on when to investigate secondary causes of hypertension.
Main Results:
- Many cases of refractory hypertension can be managed by optimizing drug doses and incorporating diuretics.
- Potent vasodilators like hydralazine or minoxidil may be necessary for persistent cases.
- Secondary causes of hypertension should be investigated in select patients based on clinical indicators.
Conclusions:
- Refractory hypertension necessitates a thorough analysis of etiologic factors.
- Rational drug selection and consideration of secondary causes are key components of management.
- Effective management strategies can improve blood pressure control in resistant cases.