[Diagnostics and treatment of resistant arterial hypertension]

Resistant arterial hypertension (RAH) is considered to be present in those cases where there is an increase in the arterial pressure (AP), if AP baseline level cannot be reduced down to 150/100 mm Hg and below that mark in conducting therapy with a triple-and-more drug regimens including diuretics and vasodilators prescribed in doses approaching the maximum ones, with the baseline (AP) level being 180/115 mm Hg and higher. The studies made permitted the development of a therapeutic RAH algorythm: use of inhibitors of the angiotensin-converting enzyme (ACE) in the complex therapy of RAH patients; naniprus is a drug of choice during therapy of low-renin refractory forms of AH; use of sodium nitroprussiate and inhibitors of ACE combined in treatment of RAH has been shown to ensure potentiation of a hypotensive effect of the above combination; prostenon is an effective means of correction of resistant forms of hypertensive disease; plasmapheresis is a reserve means in primary and symptomatic forms of RAH.