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Resistant hypertension: who and how to evaluate
Maria Czarina Acelajado1, David A Calhoun
1Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama 35294-2041, USA. czarina.acelajado@ccc.uab.edu
Current Opinion in Cardiology
|April 28, 2009
Summary
Resistant hypertension affects a growing patient group. Key associations include primary aldosteronism and obstructive sleep apnea, requiring careful diagnosis and management.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Resistant hypertension is a significant and expanding clinical challenge.
- Limited data exist on the specific characteristics and risk factors of this patient subset.
Purpose of the Study:
- To review current evidence on resistant hypertension.
- To detail risk factors, patient profiles, and diagnostic strategies.
- To highlight associations with primary aldosteronism and obstructive sleep apnea.
Main Methods:
- Literature review of recent evidence.
- Focus on diagnostic approaches for resistant hypertension.
- Emphasis on screening for secondary causes.
Main Results:
- Resistant hypertension accounts for 20-35% of hypertensive patients.
- Ambulatory blood pressure monitoring is crucial for accurate diagnosis.
- Primary aldosteronism and obstructive sleep apnea are prevalent in resistant hypertension.
- Plasma aldosterone to renin ratio aids in screening for primary aldosteronism.
- Aldosterone contributes to left ventricular mass increase.
Conclusions:
- Patients with resistant hypertension represent a distinct population.
- Unique risk factors and associations necessitate tailored clinical consideration.
- Awareness of these associations is vital for effective patient management.
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