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Evaluation and treatment of resistant or difficult-to-control hypertension

David Wojciechowski1, Vasilios Papademetriou, Charles Faselis

  • 1Department of Veterans Affairs and Georgetown University Hospital, Washington, DC 20422, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|January 9, 2009
PubMed

Insights

Optimizing medical regimens effectively lowered blood pressure in patients with resistant hypertension. Targeted adjustments to treatment plans helped achieve blood pressure goals in nearly half of participants.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Pharmacy

Background:

  • Resistant hypertension poses a significant challenge in managing cardiovascular health.
  • Adherence to established guidelines, such as the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), is crucial.

Purpose of the Study:

  • To evaluate the effectiveness of targeted medical regimen adjustments in patients with resistant or difficult-to-control hypertension.
  • To assess blood pressure control and treatment intensification in a cohort of hypertensive patients.

Main Methods:

  • An observational study involving 164 patients with resistant hypertension.
  • Treatment adjustments were made based on JNC 7 recommendations.
  • Medication data, including diuretic use and antihypertensive drug count, were tracked over 6 months.

Main Results:

  • Mean blood pressure decreased from 160/87 mm Hg at baseline to 135.55/74.55 mm Hg at 3 months and 137.62/74.03 mm Hg at 6 months (P<.0001).
  • By 6 months, 45.10% of patients achieved their blood pressure goals.
  • The average number of antihypertensive medications increased, and diuretic use became universal (100%) by 6 months.

Conclusions:

  • Targeted adjustments to antihypertensive medication regimens can significantly improve blood pressure control in patients with resistant hypertension.
  • Intensification of treatment, including increased medication use and universal diuretic administration, is effective in achieving blood pressure targets.

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