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Related Concept Videos

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension04:37

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CT-guided ozone-mediated renal denervation (RDN) by injecting an O2-O3 gas mixture around lumbar ganglia reduces antihypertensive medication burden and achieves an improved home blood pressure control rate. We present a novel, simplified, unilateral, and contrast-free RDN technique that minimizes the renal artery injury in the treatment of patients with resistant hypertension...
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Related Experiment Video

Updated: Jan 20, 2026

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

689

[Spironolactone in resistant essential hypertension].

Aurélien Lorthioir1, Inès Belmihoub2, David Fouassier3

  • 1AP-HP, hôpital européen Georges-Pompidou, hypertension unit, 20, rue Leblanc, 75015 Paris, France.

Presse Medicale (Paris, France : 1983)
|September 2, 2019
PubMed
Summary

Resistant hypertension requires specific diagnostic criteria, including out-of-office blood pressure confirmation. Treatment involves specialist referral and potentially adding spironolactone or other agents if essential resistant hypertension is confirmed.

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Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Resistant hypertension (RH) is defined as uncontrolled blood pressure (BP) despite optimal doses of three antihypertensive agents, including a diuretic, a renin-angiotensin system blocker, and a calcium channel blocker.
  • Confirmation of resistance necessitates out-of-office BP measurements and assessment of adherence and lifestyle factors.

Purpose of the Study:

  • To define resistant hypertension and outline diagnostic and management strategies.
  • To emphasize the importance of specialist referral for secondary causes and appropriate treatment escalation.

Main Methods:

  • Diagnosis involves assessing BP control on a triple therapy regimen.
  • Out-of-office BP monitoring (ambulatory or home) is crucial for confirmation.
  • Evaluation includes checking treatment compliance and excessive intake of salt or alcohol.

Main Results:

  • Resistant hypertension management requires excluding secondary causes.
  • Spironolactone is a recommended addition for essential resistant hypertension.
  • Alternative agents like beta-blockers, alpha-blockers, or centrally acting drugs may be used if spironolactone is contraindicated or causes adverse effects.

Conclusions:

  • Accurate diagnosis of resistant hypertension is key.
  • Management should be guided by hypertension specialists.
  • Pharmacological intensification with mineralocorticoid receptor antagonists or other agents is indicated for confirmed essential resistant hypertension.