Causes of resistant hypertension detected by a standardized algorithm.

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• Resistant hypertension (RH) is defined as blood pressure exceeding 140/90 mmHg despite three or more antihypertensive medications, including a diuretic, or requiring four medications for control.
• Patients with RH face increased risks for secondary causes of hypertension and may benefit from targeted diagnosis and treatment.
• Limited research exists on RH, particularly in emerging economies, highlighting the need for further investigation.

Purpose of the Study:

• To analyze specific causes of resistant hypertension in Brazilian patients using a standardized protocol.
• To evaluate the management and identify contributing factors in a cohort of patients with resistant hypertension.

Main Methods:

• A standardized protocol was applied to patients diagnosed with resistant hypertension at a specialized hypertension center in Brazil.
• Patient management involved a preformulated protocol to systematically identify the causes of RH.
• Data collection focused on clinical characteristics, secondary causes, and lifestyle factors.

Main Results:

• Patients with resistant hypertension exhibited a higher prevalence of secondary hypertension compared to the general hypertensive population.
• Sleep apnea was found to be more prevalent in the resistant hypertension group.
• Obesity, dietary non-compliance, and frequent use of antihypertensive drugs were predominant factors observed in this cohort.

Conclusions:

• Resistant hypertension in Brazil is associated with a significant prevalence of secondary causes and sleep apnea.
• Obesity, diet non-compliance, and medication adherence are key factors requiring attention in RH management.
• Standardized protocols and focused anamnesis in primary care can help identify and manage causes of resistant hypertension effectively.