Related Experiment Video
Updated: Mar 7, 2026
08:35
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
4.3K
Multidisciplinary Approach in the Treatment of Resistant Hypertension
S A Potthoff1, O Vonend2,3
1University Clinic Duesseldorf, Department of Nephrology, Medical Faculty, Heinrich-Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany. sebastian.potthoff@med.uni-duesseldorf.de.
Current Hypertension Reports
|February 11, 2017
Summary
Managing arterial hypertension is challenging due to uncontrolled blood pressure, a major risk for organ damage. A multidisciplinary approach is crucial for resistant hypertension, optimizing treatment and improving patient adherence.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Arterial hypertension is highly prevalent, with many patients having undetected or poorly controlled blood pressure.
- Uncontrolled blood pressure is a significant modifiable risk factor for cardiovascular diseases and renal damage.
- Resistant hypertension poses a management challenge, often necessitating a comprehensive, multidisciplinary strategy.
Purpose of the Study:
- To outline a multidisciplinary approach for managing challenging arterial hypertension cases.
- To emphasize the evaluation of secondary causes and optimization of treatment strategies.
- To discuss the role of various healthcare professionals and emerging interventional therapies.
Main Methods:
- Multidisciplinary team evaluation including hypertension specialists, endocrinologists, and renal diagnostics.
- Assessment for pseudohypertension, white coat hypertension, and non-adherence.
- Medication optimization, simplification, and consideration of non-pharmacological interventions.
- Exploration of interventional therapies like renal denervation, baroreflex activation, and carotid body modulation.
Main Results:
- Addressing therapy resistance requires evaluating underlying causes and optimizing medication regimens.
- Simplifying drug regimens and improving adherence are key to sustainable blood pressure control.
- Multidisciplinary approaches involving various healthcare professionals can enhance patient management and self-care.
- Interventional therapies are experimental and require further evidence from randomized controlled trials.
Conclusions:
- Effective management of arterial hypertension, especially resistant cases, relies on a thorough, multidisciplinary evaluation.
- Optimizing current treatments and enhancing patient adherence are paramount.
- Experimental interventional therapies should be reserved for clinical trials until proven effective.
Related Concept Videos
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
797
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...
797
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
1.3K
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...
1.3K
01:23Hypertension V: Nursing Management
583
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.
583
01:30Heart Failure V: Medical Management
443
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
443
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
690
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...
690
01:22Heart Failure VI: Adjunct Therapies
490
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
490