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Resistant hypertension: underlying causes and treatment.
M S Sarwar1, M S Islam, S M E Al Baker
1Department of Pharmacy, Noakhali Science and Technology University, Sonapur, Bangladesh.
Drug Research
|March 26, 2013
Summary
Resistant hypertension (RH) is a condition where blood pressure remains high despite a three-drug treatment plan including a diuretic. This review explores its prevalence, causes, and management strategies for better patient outcomes.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Resistant hypertension (RH) affects a significant, yet unknown, percentage of patients, potentially ranging from 5% to 50%.
- RH is defined as uncontrolled blood pressure despite a three-drug regimen at optimal doses, including a diuretic.
- Contributing factors include patient adherence, lifestyle, and iatrogenic causes.
Purpose of the Study:
- To review the prevalence, symptoms, causes, and treatment of resistant hypertension.
- To highlight the diverse factors contributing to RH, from lifestyle to secondary causes.
- To summarize current pharmacological and non-pharmacological management approaches.
Main Methods:
- Literature review of studies on resistant hypertension.
- Analysis of factors influencing RH prevalence and management.
- Synthesis of information on drug-induced hypertension and secondary causes.
Main Results:
- Prevalence of RH is variable and not precisely defined.
- Numerous factors contribute to RH, including non-adherence, lifestyle, and medications (e.g., NSAIDs, oral contraceptives).
- Common secondary causes include obstructive sleep apnea, renal artery stenosis, and primary aldosteronism; rarer causes also exist.
Conclusions:
- Resistant hypertension necessitates a comprehensive evaluation to identify contributing factors.
- Effective management involves addressing adherence, lifestyle, drug-induced causes, and secondary hypertension.
- Both medication and non-medication strategies are crucial for controlling blood pressure in RH patients.
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