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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
Resistant hypertension in office practice: a clinical approach
Fadi Siyam1, Stephen A Brietzke, James R Sowers
1Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Hospital Practice (1995)
|November 12, 2010
Summary
Resistant hypertension, uncontrolled blood pressure despite medication, requires evaluating secondary causes like hyperaldosteronism. Effective management involves drug combinations and considering mineralocorticoid receptor antagonists, especially in metabolic syndrome.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Resistant hypertension is defined as uncontrolled blood pressure despite ≥3 medications.
- Evaluation requires assessing measurement technique, lifestyle, comorbidities, and potential contributing factors.
- Secondary causes of hypertension are prevalent in resistant cases.
Purpose of the Study:
- To review the evaluation and management of resistant hypertension.
- To highlight the importance of identifying secondary causes, particularly hyperaldosteronism.
- To discuss current pharmacologic strategies and the role of mineralocorticoid receptor antagonists.
Main Methods:
- Literature review of resistant hypertension evaluation and treatment.
- Analysis of contributing factors, including sleep apnea, alcohol, and medications.
- Focus on screening for secondary causes and pharmacologic management.
Main Results:
- Hyperaldosteronism is increasingly recognized as a common cause of resistant hypertension.
- Diuretics are essential in combination therapy for resistant hypertension.
- Mineralocorticoid receptor antagonists show promise, especially in metabolic syndrome.
Conclusions:
- Comprehensive evaluation is crucial for resistant hypertension, including screening for secondary causes.
- Pharmacologic therapy should involve drug combinations targeting different mechanisms.
- Mineralocorticoid receptor antagonists represent an expanding therapeutic option, particularly in specific patient groups.
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