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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
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Resistant Hypertension Updated Guidelines
Irene Chernova1, Namrata Krishnan2,3
1Yale School of Medicine/Section of Nephrology, New Haven, CT, USA.
Current Cardiology Reports
|September 1, 2019
Summary
Resistant hypertension (RH) is uncontrolled blood pressure despite ≥3 medications. Diagnosis requires excluding other causes and non-adherence, with out-of-office measurements crucial. Treatment focuses on lifestyle and medication optimization.
Area of Science:
- Cardiology
- Hypertension Management
Background:
- Resistant hypertension (RH) affects a significant patient population.
- Accurate diagnosis and effective management are critical for cardiovascular health.
Purpose of the Study:
- To review the current definition and diagnostic criteria for resistant hypertension (RH).
- To discuss evidence-based treatment recommendations for RH based on recent guidelines and literature.
Main Methods:
- Review of the 2018 American Heart Association (AHA) guidelines.
- Analysis of recent scientific literature on resistant hypertension.
Main Results:
- RH defined as uncontrolled blood pressure (BP) on ≥3 antihypertensives, including a diuretic, at maximally tolerated doses.
- Diagnosis necessitates exclusion of white coat effect and medication non-adherence via out-of-office BP measurements.
- Secondary causes of hypertension must be ruled out in all RH patients.
Conclusions:
- A step-wise treatment approach, emphasizing lifestyle modifications and medication optimization, is effective in over 50% of RH patients.
- Out-of-office BP monitoring is central to RH diagnosis and management.
- Device-based interventions for RH are currently investigational and require further study.
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