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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Published on: May 26, 2022

Treatment resistant hypertension.

Peter Bolli1

  • 1Ambulatory Internal Medicine Teaching Clinic, St. Catharines, Canada. pbolli@xenomix.com

American Journal of Therapeutics
|July 23, 2008
PubMed
Summary
This summary is machine-generated.

Treatment resistant hypertension, uncontrolled by multiple medications, stems from noncompliance, drug interactions, obesity, sleep apnea, and white coat hypertension. Identifying secondary hypertension is crucial as it may be curable.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Nephrology

Background:

  • Treatment resistant hypertension (TRH) is defined as uncontrolled blood pressure despite three or more antihypertensive medications.
  • Several factors contribute to TRH, including patient noncompliance and interactions with other substances.
  • Obesity, obstructive sleep apnea, and white coat hypertension are significant contributors to resistant hypertension.

Purpose of the Study:

  • To explore the multifaceted causes of treatment resistant hypertension.
  • To highlight the importance of identifying secondary causes of hypertension.

Main Methods:

  • Review of existing literature on treatment resistant hypertension.
  • Analysis of contributing factors such as noncompliance, drug interactions, and comorbidities.
  • Discussion of diagnostic approaches for identifying secondary hypertension.

Main Results:

  • Noncompliance, often due to side effects or complex regimens, is a primary reason for treatment failure.
  • Exogenous substances like NSAIDs and OTC medications (ephedrine/pseudo-ephedrine) can counteract antihypertensive effects.
  • Obesity and obstructive sleep apnea increase sympathetic and renin-angiotensin-aldosterone system activity, opposing treatment.
  • White coat hypertension should be suspected in cases without target organ damage or with hypotension symptoms.

Conclusions:

  • Treatment resistant hypertension has diverse etiologies, necessitating a comprehensive diagnostic approach.
  • Addressing noncompliance, drug interactions, and comorbidities is essential for effective hypertension management.
  • Identifying and treating secondary hypertension offers potential for curable outcomes.