Related Experiment Video
Updated: May 16, 2026
08:35
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Resistant hypertension--its identification and epidemiology
Pantelis A Sarafidis1, Panagiotis Georgianos, George L Bakris
1Section of Nephrology and Hypertension, 1st Department of Medicine, American Hellenic Educational Progressive Association (AHEPA), University General Hospital, Aristotle University of Thessaloniki, St Kiriakidis 1, PO 54636, Thessaloniki, Greece.
Nature Reviews. Nephrology
|November 21, 2012
Summary
Resistant hypertension affects 8-12% of hypertensive adults, with higher cardiovascular risks in older, Black, obese, or diabetic patients. Further research is needed to understand true resistant hypertension epidemiology.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Resistant hypertension, defined as uncontrolled blood pressure despite optimal treatment, is increasingly recognized.
- The rising prevalence of obesity and hypertension contributes to this growing public health concern.
- Recent large-scale studies have focused on the prevalence, incidence, and risk factors of resistant hypertension.
Purpose of the Study:
- To summarize current findings on the prevalence and risk factors of resistant hypertension.
- To highlight the increased cardiovascular risk associated with resistant hypertension in specific populations.
- To emphasize the need for further research to define true resistant hypertension.
Main Methods:
- Analysis of large-scale population-based surveys, including the US National Health and Nutrition Examination Survey (NHANES).
- Examination of prevalence, incidence, and associated risk factors.
- Review of studies identifying patient subgroups at higher risk for cardiovascular events.
Main Results:
- Resistant hypertension impacts 8-12% of adult hypertensive patients, estimated at 6-9 million people.
- Patients over 55, of Black ethnicity, with high BMI, diabetes, or chronic kidney disease face increased cardiovascular event risk.
- The prevalence of resistant hypertension is rising despite overall improvements in blood pressure control.
Conclusions:
- Resistant hypertension represents a significant clinical challenge with a growing prevalence.
- Identifying high-risk populations is crucial for targeted interventions and improved cardiovascular outcomes.
- Further research is necessary to differentiate true resistant hypertension from other contributing factors like white-coat or pseudoresistant hypertension.
Related Concept Videos
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
01:28Hypertension I: Introduction
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...