Resistant hypertension in the elderly: optimizing outcomes while avoiding adverse effects

Resistant hypertension (HTN) is defined as blood pressure (BP) that remains above goal, despite the concurrent use of three antihypertensive agents of different classes. This case describes an 89-year-old patient with an extensive history of resistant HTN and a complicated medication regimen who was referred to a pharmacy services clinic for medication review and assistance in management of antihypertensive medications. After the initial visit, the patient presented to the clinic with complaints of dizziness and fatigue and was found to be hypotensive. This case study discusses the important role of the pharmacist as part of a health care team in improving medication adherence and managing a patient's BP.