Related Experiment Video
Updated: Apr 5, 2026
04:37
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
862
Resistant hypertension: what the cardiologist needs to know
Stefano F Rimoldi1, Franz H Messerli2, Sripal Bangalore3
1Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland.
European Heart Journal
|August 12, 2015
Summary
Treatment-resistant hypertension (TRH) requires careful evaluation to identify true cases and underlying causes. New device-based interventions show promise but need careful patient selection for optimal outcomes.
Area of Science:
- Cardiology
- Hypertension Management
- Interventional Cardiology
Background:
- Treatment-resistant hypertension (TRH) impacts 3-30% of hypertensive patients, increasing cardiovascular risks.
- Limited interest in TRH management historically due to care complexities.
- Emergence of novel therapies like renal denervation (RDN) and baroreceptor stimulation has renewed focus.
Purpose of the Study:
- To guide cardiologists in identifying TRH patients and their mechanisms.
- To outline strategies for selecting patients for device-based interventions.
- To review drug-based treatment strategies for TRH.
Main Methods:
- Review of current guidelines and clinical trial data.
- Emphasis on 24-hour ambulatory blood pressure monitoring and arterial stiffness assessment.
- Analysis of secondary hypertension prevalence in TRH.
Main Results:
- Initial uncontrolled RDN studies showed promising blood pressure reduction.
- Controlled studies tempered enthusiasm, highlighting the need for precise patient selection.
- Accurate identification of 'true' resistant hypertension is crucial, often involving secondary causes.
Conclusions:
- Referral to hypertension specialists is recommended for documented TRH.
- Device-based interventions require careful consideration of patient profiles and potential benefits.
- A comprehensive approach combining diagnostic work-up and tailored treatment is essential for managing TRH.
Related Concept Videos
01:28Hypertension I: Introduction
1.2K
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,...
1.2K
01:29Hypertension II: Pathophysiology
1.5K
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,...
1.5K
01:18Hypertension and Regulation of Blood Pressure
4.8K
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...
4.8K
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
729
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...
729
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
3.0K
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
3.0K
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
1.4K
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.4K