[RESISTANT ARTERIAL HYPERTENSION – APPROACH TO PATIENT IN FAMILY MEDICINE]

Area of Science:

• Cardiology
• Family Medicine
• Hypertension Research

Background:

• Resistant arterial hypertension (RAH) prevalence is increasing, posing a significant cardiovascular risk.
• RAH patients exhibit higher target organ damage and triple the risk of adverse cardiovascular events.
• RAH is defined as uncontrolled blood pressure despite lifestyle changes and three full-dose medications, including a diuretic.

Purpose of the Study:

• To highlight the importance of RAH as a cardiovascular risk factor.
• To emphasize early detection and management of RAH at the family medicine level.
• To promote timely referral for specialized treatments of specific RAH forms.

Main Methods:

• Review of current literature on resistant arterial hypertension.
• Analysis of risk factors, diagnostic criteria, and treatment strategies for RAH.
• Discussion of emerging invasive treatment modalities.

Main Results:

• Key risk factors for RAH include older age, obesity, smoking, high salt/alcohol intake, and comorbidities like diabetes and chronic kidney disease.
• Primary aldosteronism and obstructive sleep apnea are significant, often overlooked, causes of RAH.
• Combination therapy with a diuretic and mineralocorticoid antagonists shows efficacy, even without elevated aldosterone.

Conclusions:

• RAH is a critical cardiovascular risk factor requiring systematic management.
• Family physicians play a vital role in the early identification and initial treatment of RAH.
• Timely referral to specialists for advanced diagnostics and interventions like renal denervation is essential for refractory cases.